中国医药
中國醫藥
중국의약
CHINA MEDICINE
2014年
3期
338-342
,共5页
短暂性脑缺血发作%动脉狭窄%预后
短暫性腦缺血髮作%動脈狹窄%預後
단잠성뇌결혈발작%동맥협착%예후
Transient ischemic attack%Artery stenosis%Prognosis
目的 研究短暂性脑缺血发作(TIA)患者首发症状后90 d预后与脑供血动脉的狭窄特征包括狭窄程度、分布部位及斑块性质的关系.方法 对87例首发TIA住院患者进行回顾性分析,观察颅脑动脉病变情况,对其进行90 d随访.根据患者预后情况分为稳定组、频发组、脑梗死组,收集数据进行统计分析.结果 87例患者失访8例,完成随访的79例TIA患者中稳定组34例(43.0%),频发组37例(46.8%),脑梗死组8例(10.2%).3组患者血管病变特点:狭窄血管共135条,稳定组血管狭窄构成比:轻度77.4%(24/31),中度16.1%(5/31),重度3.2%(1/31),闭塞3.2%(1/31);频发组血管狭窄构成比;轻度73.9%(48/65),中度10.8%(7/65),重度4.6%(3/65),闭塞10.8%(7/65);脑梗死组血管狭窄构成比:轻度56.4%(22/39),中度10.3%(4/39),重度15.4%(6/39),闭塞17.9%(7/39).中轻度血管狭窄构成比以稳定组最高,其次为频发组,脑梗死组最低.重度和闭塞血管构成比脑梗死组最高,其次为频发组,稳定组最低.相关分析结果显示TIA预后与血管狭窄程度呈正相关(r=0.199,P=0.021).发现斑块117个,稳定组斑块构成比:钙化斑51.4%(18/35),混合斑34.3%(12/35),软斑14.3%(5/35);频发组斑块构成比:钙化斑23.5%(12/51),混合斑47.1(24/51),软斑29.4%(15/51);脑梗死组斑块构成比:钙化斑12.9%(4/31),混合斑48.4%(15/31),软斑38.7%(12/31).中稳定组钙化斑构成比最高,其次为频发组,脑梗死组最低.混合斑和软斑脑梗死组所占比例最高,其次为频发组,稳定组最低.相关分析显示TIA与血管斑块性质呈正相关(r=0.341,P=0.001).稳定组前循环血管狭窄以颈总动脉38.9%(7/18)最多见,后循环以椎动脉颅内段30.8%(4/13)多见;频发组和脑梗死组前循环狭窄以大脑中动脉32.5%(13/40)、36.8%(7/19)最多见,后循环以椎动脉颅外段36.0%(9/25)、35.0%(7/20)多见,但差异无统计学意义(P＞0.05).结论 TIA预后与脑供血动脉的狭窄程度及斑块性质有关,狭窄程度越重、斑块性质越不稳定,预后越差.
目的 研究短暫性腦缺血髮作(TIA)患者首髮癥狀後90 d預後與腦供血動脈的狹窄特徵包括狹窄程度、分佈部位及斑塊性質的關繫.方法 對87例首髮TIA住院患者進行迴顧性分析,觀察顱腦動脈病變情況,對其進行90 d隨訪.根據患者預後情況分為穩定組、頻髮組、腦梗死組,收集數據進行統計分析.結果 87例患者失訪8例,完成隨訪的79例TIA患者中穩定組34例(43.0%),頻髮組37例(46.8%),腦梗死組8例(10.2%).3組患者血管病變特點:狹窄血管共135條,穩定組血管狹窄構成比:輕度77.4%(24/31),中度16.1%(5/31),重度3.2%(1/31),閉塞3.2%(1/31);頻髮組血管狹窄構成比;輕度73.9%(48/65),中度10.8%(7/65),重度4.6%(3/65),閉塞10.8%(7/65);腦梗死組血管狹窄構成比:輕度56.4%(22/39),中度10.3%(4/39),重度15.4%(6/39),閉塞17.9%(7/39).中輕度血管狹窄構成比以穩定組最高,其次為頻髮組,腦梗死組最低.重度和閉塞血管構成比腦梗死組最高,其次為頻髮組,穩定組最低.相關分析結果顯示TIA預後與血管狹窄程度呈正相關(r=0.199,P=0.021).髮現斑塊117箇,穩定組斑塊構成比:鈣化斑51.4%(18/35),混閤斑34.3%(12/35),軟斑14.3%(5/35);頻髮組斑塊構成比:鈣化斑23.5%(12/51),混閤斑47.1(24/51),軟斑29.4%(15/51);腦梗死組斑塊構成比:鈣化斑12.9%(4/31),混閤斑48.4%(15/31),軟斑38.7%(12/31).中穩定組鈣化斑構成比最高,其次為頻髮組,腦梗死組最低.混閤斑和軟斑腦梗死組所佔比例最高,其次為頻髮組,穩定組最低.相關分析顯示TIA與血管斑塊性質呈正相關(r=0.341,P=0.001).穩定組前循環血管狹窄以頸總動脈38.9%(7/18)最多見,後循環以椎動脈顱內段30.8%(4/13)多見;頻髮組和腦梗死組前循環狹窄以大腦中動脈32.5%(13/40)、36.8%(7/19)最多見,後循環以椎動脈顱外段36.0%(9/25)、35.0%(7/20)多見,但差異無統計學意義(P＞0.05).結論 TIA預後與腦供血動脈的狹窄程度及斑塊性質有關,狹窄程度越重、斑塊性質越不穩定,預後越差.
목적 연구단잠성뇌결혈발작(TIA)환자수발증상후90 d예후여뇌공혈동맥적협착특정포괄협착정도、분포부위급반괴성질적관계.방법 대87례수발TIA주원환자진행회고성분석,관찰로뇌동맥병변정황,대기진행90 d수방.근거환자예후정황분위은정조、빈발조、뇌경사조,수집수거진행통계분석.결과 87례환자실방8례,완성수방적79례TIA환자중은정조34례(43.0%),빈발조37례(46.8%),뇌경사조8례(10.2%).3조환자혈관병변특점:협착혈관공135조,은정조혈관협착구성비:경도77.4%(24/31),중도16.1%(5/31),중도3.2%(1/31),폐새3.2%(1/31);빈발조혈관협착구성비;경도73.9%(48/65),중도10.8%(7/65),중도4.6%(3/65),폐새10.8%(7/65);뇌경사조혈관협착구성비:경도56.4%(22/39),중도10.3%(4/39),중도15.4%(6/39),폐새17.9%(7/39).중경도혈관협착구성비이은정조최고,기차위빈발조,뇌경사조최저.중도화폐새혈관구성비뇌경사조최고,기차위빈발조,은정조최저.상관분석결과현시TIA예후여혈관협착정도정정상관(r=0.199,P=0.021).발현반괴117개,은정조반괴구성비:개화반51.4%(18/35),혼합반34.3%(12/35),연반14.3%(5/35);빈발조반괴구성비:개화반23.5%(12/51),혼합반47.1(24/51),연반29.4%(15/51);뇌경사조반괴구성비:개화반12.9%(4/31),혼합반48.4%(15/31),연반38.7%(12/31).중은정조개화반구성비최고,기차위빈발조,뇌경사조최저.혼합반화연반뇌경사조소점비례최고,기차위빈발조,은정조최저.상관분석현시TIA여혈관반괴성질정정상관(r=0.341,P=0.001).은정조전순배혈관협착이경총동맥38.9%(7/18)최다견,후순배이추동맥로내단30.8%(4/13)다견;빈발조화뇌경사조전순배협착이대뇌중동맥32.5%(13/40)、36.8%(7/19)최다견,후순배이추동맥로외단36.0%(9/25)、35.0%(7/20)다견,단차이무통계학의의(P＞0.05).결론 TIA예후여뇌공혈동맥적협착정도급반괴성질유관,협착정도월중、반괴성질월불은정,예후월차.
Objective To explore the correlation between prognosis of transient ischemic attack(TIA) with the characteristic of cerebral arteries stenosis and plaque. Methods A retrospective clinical analysis was performed on the clinical data from 87 patients with the first time attack of TIA. The patients were divided into favorable prognosis group, frequent attacks group and cerebral infarction group. Results Favorable group had 34 cases, frequent attacks group had 37 cases and cerebral infarction group had 8 cases. In favorable group, there were mild stenosis 77.4%(24/31) position and calcific plaque 51.4%(18/35); the least was cerebral infarction group(mild stenosis 56.4%, calcific plaque 12.9%). The severe stenosis, occlusion and soft plaque in favorable group was least(severe stenosis 3.2%, occlusion 3.2%, soft plaque 14.3%); the highest was cerebral infarction group(severe stenosis 15.4%, occlusion 17.9%, soft plaque 38.7%). The positive rate nature of plaques and the stenosis degree of artery were significantly different among the three groups(all P＜0.05). The CCA was the frequent stenosis in anterior circulation at favorable group[38.9%(7/18], the ICVA was the frequently stenosis in posterior circulation at favorable group [30.8%(4/13)],the MCA was the frequently stenosis in posterior circulation between frequent attacks group [32.5%(13/40)] and cerebral infarction group [36.8%(7/19)]; the ECVA was the frequently stenosis in posterior circulation between frequent attacks group [36.0%(9/25)]and cerebral infarction group [35.0%(7/20)](P>0.05). Conclusions In this study the short time prognosis of TIA is associated with the stenosis degree of artery and nature of plaques. The severe stenosis and unstable plaque suggest poor prognosis.
