短暂性脑缺血发作持续时间与脑梗死关系的研究

The relationship between duration of transient ischemia attack and cerebral infarction

目的探讨短暂性脑缺血发作(TIA)持续时间与脑梗死的关系。方法316例TIA患者,根据临床表现将其分为颈内动脉系统TIA组,178例;椎基底动脉系统TIA组,127例;分类不明确TIA组,11例。详细记录其发作持续时间、发作次数。发作时(后)行头部CT或MRI检查,部分病例于发作后24～48h内复查。分别记录各TIA组发病持续时间≤60min与>60min患者影像学异常(责任病灶)例数。结果颈内动脉系统TIA、椎基底动脉系统TIA及分类不明确TIA,发作持续时间平均值分别为(14.6±2.3)min、(8.8±1.7)min及(11.6±2.1)min。TIA发作持续时间≤60min患者发生脑梗死比例,分别为7/164、4/117及1/10;>60min者为9/14、7/10和1/1,组间比较差异均具有显著意义(P<0.01)。结论局灶的神经功能障碍持续时间≤1h的TIA患者发生脑梗死的概率明显低于持续时间>1h的患者。

Objective To study the correlation between duration of transient ischemia attack (TIA) and cerebral infarction. Methods 316 patients of TIA (178 cases due to internal carotid circulation, 127 cases due to vertebra-basal artery circulation ischemia, and 11 cases unidentified)were studied about the duration and frequency of attacks in detail. All of the patients were examined by CT or MRI, and some of them were repeated after 24~48 h. The difference of brain infarction between the duration of ischemic attack last more or less than 60 min was compared respectively. Results The averages of duration in TIA of internal carotid circulation, vertebra-basal artery circulation and unidentified group were (14.6 ± 2.3)min, (8.8 ± 1.7)min and(11.6 ± 2.1)min respectively. In cases that TIA persisting for less than 60 min, the brain infarction rates were 7/164、4/117 and 1/10 respectively;and that TIA persisting for more than 60 min, the brain infarction rates were 9/14、7/10 and 1/1 respectively. There were significant difference between the two groups (P < 0.01). Conclusion The possibility of stroke in TIA patients with less than an hour attack is much less than those with more than an hour duration.