TIA与TIA形式的脑梗死的相关因素分析

目的分析TIA及TIA形式的脑梗死的临床特点,探索其临床相关因素。方法回顾性分析83例初步诊断为TIA并在症状首发后24 h内行常规MRI及DWI检查的患者,发病1周内行颈部动脉血管彩超、TCD。记录发病后7 d内的临床转归。根据DWI结果分为DWI+组及DWI-组,确定DWI阳性率。比较DWI+组及DWI-组临床特征差别。分析两组患者动脉粥样硬化斑块的部位、性质、数量及颅内外血管狭窄的部位、程度。结果DWI阳性率为36.1%。DWI阳性与动脉粥样硬化相关(P=0.03),与颈部动脉动脉粥样硬化斑块数目相关(P=0.04),TIA症状首发后7 d内,30.0%DWI+组患者TIA症状反复发作或表现为临床症状持续存在,高于DWI-组(22.6%)。结论临床表现为TIA的病例大于1/3急性期已经形成了脑梗死,动脉粥样硬化斑块数量越多,DWI阳性的可能性越大,DWI+的患者7 d内更易进展。

Relative analysis between transient ischemic attacks and cerebral infarction displaying transient ischemic attacks

Objective The purpose of this study was to analyze clinical features between transient ischemic attacks and cerebral infarction displaying transient ischemic attacks,to explore the relative clinical factors.Methods A retrospective analysis was performed on 83 patients diagnosed as TIA entered in neurology department.All patients underwent MRI and DWI scan<24 hours after symptoms onset.TCD and neck arterial color dopplar ultrasound or(and) CTA were performed within 1 week after symptoms onset.We separate the TIA patients to two parts:with or without DWI abnormalities,to identify the positive rate of DWI abnormalities.We compared the risk factors,clinical symptoms,likely etiology,assisted examinations and prognosis(7 days) of the two part.Compare the distribution,degree of intra and extra cranial artery stenosis,analyze the distribution,type of atheromatous plaque.Results 30 out of 83 TIA patients (36.1%) revealed focal abnormalities on DWI. The large artery atherosclerosis was related to the positive rate of DWI(P=0.03). The number of atheromatous plaque in large artery atherosclerosis was related to the positive rate of DWI(P=0.04). Within 7 days after TIA outbreaks,the prognosis of DWI+ (30.0%) was higher than DWI-(22.6). Conclusion More than 1/3 patients displaying TIA had DWI abnormalities,it has already formed the cerebral infarction. The large artery atherosclerosis is relate to positive of DWI,the more atheromatous plaque,the more positive frequency of DWI. The patient of DWI+are more likely to develop into persisting clinical symptoms within 7 days.