老年性短暂性脑缺血对继发性脑梗死的临床研究

摘要

目的 研究分析老年性短暂性脑缺血发作(TIA)对继发性脑梗死的影响.方法 采取回顾性对照分析方法,选取本院收治的老年脑梗死患者118例,均为首次发病.依据发病前有无TIA发作将患者分组,其中无TIA者80例为对照组,合并TIA者38例为试验组.记录两组患者详细临床资料,比较其脑梗死面积、实验室检查结果、发病后神经功能缺损评分(MESSS)以及预后情况.结果 试验组脑梗死面积[(5.3±1.8) cm3比(8.7±2.1) cm3]及MESSS评分[(15.4±3.2)比(19.6±3.4)]均低于对照组(P＜0.05),而ADL评分高于对照组[(64.4±5.7)比(52.6±5.5),P＜0.05].实验室检查显示试验组超敏C反应蛋白(hs-CRP)水平低于对照组[(5.8±1.1) mg/L比(8.5±1.6) mg/L,P＜0.05],而纤维蛋白原(FIB)水平低于对照组[(3.0±0.6)g/L比(3.8±0.8) g/L,P＜0.05].结论 老年性TIA有助于降低继发脑梗死患者神经功能缺损程度,减少脑梗死面积,改善患者预后.%Objective To investigate the clinical effect of transient ischemic attack (TIA) on secondary cerebral infarction in elderly patients.Methods 118 elderly patients with cerebral infarction were selected,and were grouped according to whether TIA occurred before the onset of cerebral infarction or not,80 cases without TIA as the control group,and 38 cases with TIA as the experimental group.The clinical data of two groups were recorded,the cerebral infarction area,the results of laboratory examination,neurological deficit score (MESSS),and prognosis were compared.Results The area of cerebral infarction and the MESSS score in the experimental group were lower than those in the control group [(5.3±1.8)cm3 vs.(8.7±2.1)cm3,(15.4±3.2) vs.(19.6±3.4);P＜0.05],but the ADL score was higher than that in the control group [(64.4±5.7) vs.(52.6±5.5);P＜0.05].Laboratory tests showed that the level of hs-CRP in the experimental group was lower than that in the control group [(5.8±1.1)mg/L vs.(8.5±1.6)mg/L;P＜0.05],FIB level was lower than that in the control group [(3.0±0.6)g/L vs.(3.8±0.8) g/L;P＜0.05].Conclusion TIA was useful to reduce the degree of neurologic impairment,reduce infarct size,improve prognosis in patients with secondary cerebral infarction.