短暂性脑缺血发作对继发脑梗死的影响及其危险因素研究

Effect of Transient Cerebral Ischemia on Secondary Cerebral Infarction and Its Risk Factors

目的探讨短暂性脑缺血发作(TIA)对继发脑梗死的影响及其危险因素。方法选择我院2010年12月—2011年12月收治的首发脑梗死患者128例,将其中合并TIA者49例作为观察组,无TIA者79例作为对照组。记录两组患者一般情况,比较两组患者实验室检查结果、脑梗死体积、神经功能缺损程度及预后分级;影响因素的分析采用多因素Logistic回归分析。结果观察组患者纤维蛋白原水平低于对照组(P<0.05),脑梗死体积小于对照组(P<0.05),神经功能缺损程度轻于对照组(P<0.05),预后分级优于对照组(P<0.05);多因素Logistic回归分析结果显示,纤维蛋白原水平进入回归方程(P<0.05)。结论 TIA有助于减少继发脑梗死患者脑梗死体积,降低患者神经功能缺损程度,改善患者预后,其机制可能与耐受缺血有关;纤维蛋白原水平升高是TIA后继发脑梗死的独立危险因素。

Objective To investigate the effect of transient ischemic attack （TIA） on secondary c.~rebral infarction and its risk factors. Methods A total of 128 patients with cerebral infarction treated in our hospital from December 2010 to December 2011 were included in this study. Based on the occurrence of ipsilateral TIA, the patients were divided into two groups, namely the test group of 49 patients with TIA and the control group of 79 patients without TIA. The cerebral infarction volume, neurological deficits, prognostic classification, and the laboratory results such as blood glucose, blood lipid, the levels of serum creatinine and fibrinogen were compared between the two groups. And multivariate Logistic regression was performed to determine the influence factors. Results The volume of cerebral infarction, the degree of neurological deficits, and the level of serum fi- brinogen were lower in test group than those in the control group （ P 〈 0. 05 ） , while the prognosis of the test group was better than that of the control group. Multivariate Logistic regression analysis showed that fibrinogen was significantly correlated with TIA in patients with cerebral infarction （ P 〈 O. 05 ）. Conclusion TIA may reduce the volume of cerebral infarction and the neuro- logical injury, and improve the prognosis of the patients, which might be related to the brain＇s tolerance to ischemia. Fibrinogen is one risk factor of secondary cerebral infarction, whose level can be used as auxiliary index of the prognosis of patients with TIA.