高海拔地区短暂性脑缺血发作进展至脑梗死危险因素分析

目的探讨高海拔地区短暂性脑缺血发作（TIA）进展至脑梗死的危险因素。方法对255例急性TIA患者按年龄分为老年组（166例）、非老年组（89例）,根据临床表现及头颅TCD分为颈动脉系统TIA组（146例）、椎-基底动脉系统TIA组（109例）,结合相关检测结果进行综合分析。结果255例TIA患者中有96例（37.6%）发生脑梗死,其中老年组脑梗死发生率45.8%（76/166）,非老年组脑梗死发生率22.5%（20/89）,两组差异有统计学意义（P〈0.01）,且与24 h内发生TIA的频率相关（P〈0.01）。此外,脑梗死的发生与TIA首次发作至治疗时间、血压、血糖、胆固醇水平等因素相关（P〈0.05）。结论在高海拔地区脑梗死的发生率与年龄和TIA发生频率相关;伴相高血压、高血脂、高血粘度、高血糖者TIA进展至脑梗死的危险性增加。

ANALYSIS OF THE RISK FACTORS OF CEREBRAL INFARCTION CAUSED BY TRANSIENT ISCHMIA ATTACK AT HIGHER ALTITUDE

Objective To investigate the risk factors of cerebral infarction caused by transient ischemic attack(TIA) at higher attitude.Methods 255 patients with acute TIA were divided into elder age group(166 cases) and non-elderly group(89 cases)by age,and into Cervical Arteries group(146 cases) and Vertebral-basic Arteries group(109 cases) according to their clinical manifestation and cerebral transcranial doppler sonography(TCD).Comparison of incidence of TCD and outcome were analyzed in age,pathologic-type,and so on.Results The total incidence of cerebral infarction after TIA was 37.6%(96/255);it is 45.8%(76/166)in elder age group and 22.5%(20/89)in non-elderly group respectively,there is significant difference between two groups(P<0.05).Moreover,the results also showed that cerebral infarction is significantly correlated with the frequency of TIA onset(P<0.01).And treatment time,blood pressure,blood fat and cholesterol were correlated with prognostic factor in advanced cerebral infarction(P<0.05).Especially the risk of cerebral infarction increased in higher altitude.Conclusion In present study,Age and frequency of TIA onset was main determined predictor for TIA developed to cerebral infarction.The other risk factors including high blood pressure,high blood fat,high blood viscosity and high blood glucose,especially at higher altitude.