中华老年医学杂志
中華老年醫學雜誌
중화노년의학잡지
Chinese Journal of Geriatrics
2013年
11期
1169-1172
,共4页
丁立东%徐运%茆华武%肖章红%郭俊华%陈珏
丁立東%徐運%茆華武%肖章紅%郭俊華%陳玨
정립동%서운%묘화무%초장홍%곽준화%진각
脑缺血发作,短暂性%磁共振成像,弥散%磁共振血管造影术
腦缺血髮作,短暫性%磁共振成像,瀰散%磁共振血管造影術
뇌결혈발작,단잠성%자공진성상,미산%자공진혈관조영술
Ischemic attack,transient%Diffusion magnetic resonance imaging%Magnetic resonance angiography
目的 探讨磁共振血管成像(MRA)、磁共振弥散加权成像(DWI)和ABCD2评分结果与短暂性脑缺血发作(TIA)后继发脑梗死的相关性. 方法 回顾性分析162例TIA患者的颅内血管MRA、头颅DWI和ABCD2评分结果,采用Log-rank检验的Kaplan-Meier曲线评估单变量对TIA后无卒中生存时间的影响,Cox多变量回归分析评价MRA、DWI及ABCD2评分结果预测TIA后进展为脑梗死的风险比(HR)和95％可信区间(CI). 结果 162例患者中首次TIA发作后90 d内进展为脑梗死的患者共86例(53.1％),其中0～7 d继发脑梗死者22例(13.6％),8～30 d继发脑梗死者27例(16.7％),31～90 d继发脑梗死者37例(22.8％).Kaplan-Meier单因素分析显示,MRA提示中-重度颅内血管狭窄、DWI阳性和中-高危ABCD2评分与首次TIA发作后进展为脑梗死时间明显相关(P=0.000、0.003、0.000).Cox多因素风险模型结果显示,年龄(≥70岁)(HR=1.782,95％CI:1.171～2.256)、中-重度颅内血管狭窄程度(HR=2.245,95％CI:1.627～3.097)、DWI阳性(HR=1.964,95％CI:1.273～3.031)、中-高危ABCD2评分(HR=1.204,95％CI:1.050～1.381)为TIA发作后90 d内继发脑梗死的危险因素(P=0.023、0.000、0.002、0.008). 结论 颅内血管狭窄的评估可能较DWI检查和ABCD2评分对TIA的转归更具评估价值.
目的 探討磁共振血管成像(MRA)、磁共振瀰散加權成像(DWI)和ABCD2評分結果與短暫性腦缺血髮作(TIA)後繼髮腦梗死的相關性. 方法 迴顧性分析162例TIA患者的顱內血管MRA、頭顱DWI和ABCD2評分結果,採用Log-rank檢驗的Kaplan-Meier麯線評估單變量對TIA後無卒中生存時間的影響,Cox多變量迴歸分析評價MRA、DWI及ABCD2評分結果預測TIA後進展為腦梗死的風險比(HR)和95％可信區間(CI). 結果 162例患者中首次TIA髮作後90 d內進展為腦梗死的患者共86例(53.1％),其中0～7 d繼髮腦梗死者22例(13.6％),8～30 d繼髮腦梗死者27例(16.7％),31～90 d繼髮腦梗死者37例(22.8％).Kaplan-Meier單因素分析顯示,MRA提示中-重度顱內血管狹窄、DWI暘性和中-高危ABCD2評分與首次TIA髮作後進展為腦梗死時間明顯相關(P=0.000、0.003、0.000).Cox多因素風險模型結果顯示,年齡(≥70歲)(HR=1.782,95％CI:1.171～2.256)、中-重度顱內血管狹窄程度(HR=2.245,95％CI:1.627～3.097)、DWI暘性(HR=1.964,95％CI:1.273～3.031)、中-高危ABCD2評分(HR=1.204,95％CI:1.050～1.381)為TIA髮作後90 d內繼髮腦梗死的危險因素(P=0.023、0.000、0.002、0.008). 結論 顱內血管狹窄的評估可能較DWI檢查和ABCD2評分對TIA的轉歸更具評估價值.
목적 탐토자공진혈관성상(MRA)、자공진미산가권성상(DWI)화ABCD2평분결과여단잠성뇌결혈발작(TIA)후계발뇌경사적상관성. 방법 회고성분석162례TIA환자적로내혈관MRA、두로DWI화ABCD2평분결과,채용Log-rank검험적Kaplan-Meier곡선평고단변량대TIA후무졸중생존시간적영향,Cox다변량회귀분석평개MRA、DWI급ABCD2평분결과예측TIA후진전위뇌경사적풍험비(HR)화95％가신구간(CI). 결과 162례환자중수차TIA발작후90 d내진전위뇌경사적환자공86례(53.1％),기중0～7 d계발뇌경사자22례(13.6％),8～30 d계발뇌경사자27례(16.7％),31～90 d계발뇌경사자37례(22.8％).Kaplan-Meier단인소분석현시,MRA제시중-중도로내혈관협착、DWI양성화중-고위ABCD2평분여수차TIA발작후진전위뇌경사시간명현상관(P=0.000、0.003、0.000).Cox다인소풍험모형결과현시,년령(≥70세)(HR=1.782,95％CI:1.171～2.256)、중-중도로내혈관협착정도(HR=2.245,95％CI:1.627～3.097)、DWI양성(HR=1.964,95％CI:1.273～3.031)、중-고위ABCD2평분(HR=1.204,95％CI:1.050～1.381)위TIA발작후90 d내계발뇌경사적위험인소(P=0.023、0.000、0.002、0.008). 결론 로내혈관협착적평고가능교DWI검사화ABCD2평분대TIA적전귀경구평고개치.
Objective To evaluate the association of magnetic resonance angiography (MRA),diffusion-weighted imaging (DWI) and the ABCD2 score assessments with secondary cerebral infarction after transient ischemic attack (TIA).Methods Intracranial vascular MRA,cranial DWI and ABCD2 score were retrospectively analyzed in 162 cases with TIA.The impact of TIA on survival time was assessed using the univariate Kaplan-Meier curve by Log-rank test.Hazard ratio (HR) and 95 ％ confidence interval (CI) of secondary cerebral infarction after TIA predicted by MRA,DWI and ABCD2 score were analyzed by Cox multivariable regression.Results Among the 162 patients with first attack of TIA,86 cases (53.1 ％) developed cerebral infarction within 90 d,of which 22 cases (13.6％) developed secondary cerebral infarction within 0 7 d,27 cases (16.7％) within 8～30d and 37 cases (22.8％) within 31-90 d.Single factor analysis by Kaplan-Meier curve showed that moderate to severe intracranial vascular stenosis diagnosed by MRA,positive DWI and moderate to high ABCD2 score were obviously related to cerebral infarction after first attack of TIA (all P＜0.001 or 0.01).Cox multifactor risk model indicated that age ≥70 y,moderate to severe intracranial vascular stenosis,positive DWI,moderate to high ABCD2 score were the risk factors for secondary cerebral infarction within 90 d after TIA (HR=1.782,2.245,1.964,1.204,95％CI:1.171-2.256,1.627 3.097,1.273-3.031,1.050-1.381,respectively,P＜0.05,0.01 or 0.001).Conclusions Intracranial artery stenosis examination may be more valuable than DWI and ABCD2 score in evaluating the outcome of TIA.
