短暂性脑缺血发作对脑缺血耐受影响的初步研究

The Clinical Study of Transient Ischemic Attack on Cerebral Ischemic Tolerance

摘要: 目的：探讨短暂性脑缺血发作(transient ischemic attack, TIA)与脑梗死间的相关性。方法：根据患者脑梗死前是否发生同侧TIA，将所有研究对象分为TIA组和对照组，将2组人群脑梗死体积和临床神经功能缺损程度评分进行比较；同时观察TIA组患者TIA发作持续时间、发作次数等因素对脑梗死体积和临床神经功能缺损的影响。结果：先发TIA患者的脑梗死体积和临床神经功能缺损评分均显著低于对照组(P < 0.05)。TIA持续时间、发作次数、同型半胱氨酸、超敏C反应蛋白等因素均对脑梗死体积和临床神经功能缺损评分产生显著影响。结论：先发TIA有可能对后继脑梗死患者的脑细胞有一定的积极作用，并且脑梗死体积和临床神经功能缺损程度与特定的TIA发作持续时间、发作次数、同型半胱氨酸、超敏C反应蛋白显著相关。 Objective: To explore whether transient ischemic attack (TIA) is significantly associated with subsequent cerebral infarction. Methods: A total of 415 patients were enrolled in this study and were divided into TIA (n = 205) and control group (n = 210), based on presence or absence of TIA before the ischemic cerebral infarction occurrence. The cerebral infarct volume and Neurological deficit scores were compared between the two groups. Furthermore, multiple linear model analysis was conducted to evaluate the impact of TIA on the volume of infarction and Neurological deficit scores in patients who had TIA before. Results: The volume of cerebral infarction and Neurological deficit scores in patients with TIA were significantly lower than those of the control group (P < 0.05). TIA duration, TIA frequency, level of Homocysteine and Hypersensitive C-reactive protein were significantly associated with the volume of cerebral infarction and Neurological deficit scores (P < 0.05). Conclusion: Prior TIA may have a positive impact on the cells of brain. The duration and frequency of TIA and level of Homocysteine and Hypersensitive C-reactive protein are independent risk factors of the volume of cerebral infarction and Neurological deficit scores.