短暂性脑缺血发作后短期进展为脑梗死的危险因素分析

The risk factor analysis of progressing to cerebral infarction after transient ischemic attack

目的：分析短暂性脑缺血（TIA）发作患者短期内进展为脑梗死的危险因素。方法：选取92例TIA患者为研究对象，将30d内进展为脑梗死的24例患者纳入观察组，未进展患者68例纳入对照组，单因素分析TIA进展为脑梗死的影响因素，对有意义的影响因素进行多因素logistic分析，并采用ABCD2评分法观察短暂性脑梗死患者30d内进展为脑梗死的情况。结果：2组患者在高血压、糖尿病、冠心病、症状持续时间、颅内动脉狭窄等影响因素差异均有统计学意义（P〈0．05-P〈0．01）。多因素logistic回归分析发现颅内动脉狭窄、症状持续时间≥60min、糖尿病、高血压和冠心病均为TIA短期内进展为脑梗死的危险因素（P〈0．05－P〈0．01）。不同ABCD2评分，TIA患者短期内进展为脑梗死的发生率差异有统计学意义（P〈0．05）。结论：ABCD2评分不但包括糖尿病、高血压等危险因素，还有症状评分等项目，临床使用方便，结合影像学检查将提高其准确性。

Objective：To analyze the risk factor which progressing to cerebral infarction（CI） after transient ischemic attack（TIA） in a short term. Methods ：Twenty-four cases of the total 92 TIA patients who progressing to CI were included into experimental group and the rest 68 patients were included into control group. Used single factor analysis, the influence factors of CI which progressed from TIA were analyzed by multi-factor logistic analysis. The progression to CI of the different ABCD2 scores in 30 days were observed. Results ： There were significant differences between the two groups in hypertension, diabetes, coronary artery disease, symptoms duration time and intracranial artery stenosis （P 〈 0. 05 to P 〈 0. 01 ）. The results of muhi-factor analysis showed that intracranial artery stenosis, symptoms duration time which was longer than 60 minutes, diabetes, hypertension and coronary artery disease were all the risk factors of the progression （P 〈 0.05 to P 〈 0.01 ）. The scores of ABCD2 was highe, the possibility of progression to CI was increased （P 〈 0.05 ）. Conclusions：ABCD2 scale not only includes the risk factors of diabetes and hypertension, also contains the assessment of symptom. ABCD2 scale is convenient to be used in clinic and the accuracy will be enhanced if combining with imaging examine.