内囊预警综合征患者脑梗死的危险因素

Risk factors for cerebral infarction in patients with capsular warning syndrome

目的探讨内囊预警综合征（capsular warning syndrome，CWS）患者发生脑梗死的危险因素。方法回顾性连续收集符合CWS临床表现起病形式的短暂性脑缺血发作（transient ischemic attack，TIA）患者，根据颅脑弥散加权成像结果分为脑梗死组和非脑梗死组，通过比较人口统计学和基线临床资料确定CWS患者发生脑梗死的独立危险因素。结果共纳入39例患者，其中男性25例（64．1％），女性14例（35．9％），年龄（58．9±10．3）岁；脑梗死组21例，非脑梗死组18例。与非脑梗死组比较，脑梗死组年龄较大[（62．5±9．3）岁对（54．8±10．2）岁；t=2．470，P=0．018]，既往卒中或TIA史构成比较高（33．3％对5．6％；P=0．049），空腹血糖水平较高[（8．2±3．2）mmol／L对（6．0±1．3）mmol／L；t=2．748，P=0．009]，ABCD。评分较高[（5．2±1．1）分对（3．5±1．1）分；t=4．734，P〈0．001]。多变量logistic回归分析显示，ABCD。评分是CWS患者脑梗死的独立危险因素（优势比4．529，95％可信区间1．233～16．627；P=0．023）。结论ABCD。评分较高是CWS患者发生脑梗死的独立危险因素，可作为预测CWS患者脑梗死风险的评价工具。

Objective To investigate the risk factors for the occurrence of cerebral infarction in patients with capsular warning syndrome （CWS）. Methods Consecutive patients with transient ischemic attack （TIA） meeting the CWS clinical manifestations were collected retrospectively. They were divided into either a cerebral infarction group or a non-cerebral infarction group according to the brain diffusion weighted imaging findings. The independent risk factors for patients with CWS were identified through the comparison of demographic and baseline clinical data. Results A total of 39 patients were enrolled, including 25 males （64. 1%） and 14 females （35.9%）, and their mean age was 58. 9 ＋ 10. 3 years. There were 21 patients in the cerebral infarction group and 18 in the non-cerebral infarction group. Compared with the noncerebral infarction group, the age of patients in the cerebral infarction group was older （62. 5 ±9. 3 years vs. 54. 8 ± 10. 2 years; t =2. 470, P =0. 018）. The constituent ratio of the patients with a history of previous stroke or transient ischemic attack was higher （33.3% vs. 5. 6%; P=0. 049）, the fasting blood glucose level was higher （8.2 ±3.2 mmol/L vs. 6. 0 ± 1.3 mmol/L; t =2. 748, P =0. 009）, and ABCD2 score was higher （5.2 ± 1.1 vs. 3.5 ± 1.1; t =4. 734, P 〈0. 001）. Multivariate logistic regression analysis showed that the ABCD2 score was an independent risk factor for cerebral infarction in patients with CWS （odds ratio, 4. 529, 95% confidence interval 1. 233 - 16. 627; P =0. 023）. Conclusions The higher ABCD2 score was an independent risk factor for the occurrence of cerebral infarction in patients with CWS. It can be used as an evaluation tool for predicting the risk of cerebral infarction in patients with CWS.