颈内动脉系统TIA预后的预测研究

THE PREDICTORS OF COMPLETE INFARCTION IN PATIENTS WITH CAR OTID TRANSIENT ISCHEMIC ATTACKS

目的:探讨颈内动脉系统短暂性脑缺血发作(TIA)发展为完全缺血性脑梗死的预测因子及预后模式。方法:采用以医院为基础的队列研究,对近4年颈内动脉系统TIA门诊或住院病人84例进行随访调查。结果:发现其1个月、1年、2年及3年完全性脑梗死的累积发生率分别为7.14%、13.9%、28.14%及46.15%。多因素分析显示:年龄、家族卒中史、高血压、血浆粘度、全血低切粘度等是影响预后的独立危险因素。结论:提示在缺血性脑卒中二级预防工作中,可将高血压、家族卒中史、血浆粘度、全血低切粘度作为识别高危复发人群的重要标志。

Objective:To determine the important prognostic factors which identify patients with carotid transient ischemic attacks who are at high risk of complete infarction and to derive a predication model (equation).Methods:A hospital based cohort of 84 patients affected by carotid TIA was investigated and followed up during 1994~1999 Results:The results showed that 26 cases had developed complete infarction ,1 month,1,2 and 3 years cumulative occurrence rates were 7 14%,13 9%,28 14% and 46 15% respectively By Cox proportional hazards analysis it was found that there were five independent risk factors of ischemic stroke: history of family stroke history (RR:7 355,P=0 016 9),hypertension (RR:4 039,P=0 096 2),elevated plasma viscosity (RR:1 681,P=0 085 8),elevated whole blood low shear viscosity (RR:1 568,P=0 186 1)and age (RR:0 791,P=0 191 6) Conclusion:Age,hypertension,history of family stroke history and abnormal of hemorheology were important marks of bad prognosis In secondary prevention of TIA,taking hypotensor regularly and intervening hemorheology abnormal were effective preventive measures to control risk factors