短暂性脑缺血发作患者短期发生脑梗死的危险因素分析

目的分析短暂性脑缺血发作(TIA)患者7d和30d内进展为脑梗死的危险因素。方法以119例住院TIA患者为研究对象,收集其临床资料和磁共振血管成像(MRA)结果,并按Johnston提出的7分"ABCD2"评分法给予评分,随访发生TIA后7d和30d内脑梗死的发生率。结果 TIA发生后50例(42.0%)患者于30d内发生脑梗死,其中29例(24.4%)发生于7d内。Logistic回归分析发现,症状持续时间≥10min、ABCD2评分≥4分是TIA后7d发生脑梗死的独立危险因素;发作次数≥3次、颅内动脉狭窄≥50%是TIA后30d发生脑梗死的独立危险因素。抗凝治疗是TIA进展为脑梗死的保护因素。结论发作持续时间长、次数多、颅内动脉狭窄重和"ABCD2"评分高的TIA患者短期内脑梗死发生危险性较高,抗凝治疗可使TIA患者有降低脑梗死发生的风险性。

Analysis of risk factors in patients with cerebral infarction resulting from transient ischemic attack

Objective To investigate the risk factors influenting transient ischemic attack （TIA） to evolve into cerebral infarction in 7day and 30day . Methods The clinical data and magnetic resonance angiography（MRA） findings were analyzed in 119 hospitalized cases with TIA. The ＂ABCD2＂score was applied to all the patients and used to analysis the 7day risk of cerebral infarction. Results A total of 50（42.0%） patients had cerebral infarction within 30 days after symptoms ,while 29（24.4%） patients occurred with in 7 days. By multiple Logistic regression analysis,the＂ABCD2＂score≥4 and the symptoms lasting over 10 minutes were independently associated with 7-day risk of cerebral infarction.At the same time, intracal arterial stenosis ≥50% and time of attack ≥3 were independently associated with 30-day risk of cerebral infarction. Anticoagulant therapy was a protectant factor. ConclusionThere is high danger for patients to develop cerebral infarction patients with TIA lasted for a long time, frequent attacks, serious intracal arterialstenosis, or high ＂ABCD2＂ score. Anticoagulant therapy is a protectant factor.