短暂性脑缺血发作和后继脑梗死关系研究.docVIP

短暂性脑缺血发作和后继脑梗死关系研究 　　【摘要】 目的 探讨短暂性脑缺血发作（TIA）对后继脑梗死是否有保护作用。方法 选2008年1月至2010年4月首次因脑梗死入住包头市第四医院的患者218例。按患者脑梗死前是否发生同侧TIA将其分为TIA组与非TIA组，前者按发作持续时间又分为两组，持续时间不超过20 min为A组(54例)，持续时间超过20 min为B组（42例），非TIA组为C组（122例），记录三组患者发病当天与病程两周时神经功能缺损评分和梗死病变体积，进行比较。结果 发病当天及病程两周时A组神经功能缺损评分低于B组和C组，差异有统计学意义（P0.05）；三组患者发病当天及病程两周时A组梗死病变体积小于B组和C组，差异有统计学意义（P0.05）。结论 TIA有一定的脑保护作用，且其有一定的缺血时间限制。? 　　【关键词】 短暂性；脑缺血发作；脑梗死；时间 　　?? 　　The study on the relationship between transient ischemic attack and a subsequent cerebral infarction 　　 　　LIN Li-ming,FAN Yue-tao,FAN Gui-ling.Department of Neurology,Fourth Hospital of Baotou City,014030,China 　　? 　　【Abstract】 Objective To evaluate whether transient ischemic attack has the protective effects on subsequent acute cerebral infarction(CI). Methods 218 patients who were hospitalized for the first time because of CI. According to whether they had ipsilateral TIAs in advance, these patients were divided into two groups:the group with TIAs and the group without TIAs. And 96 patients with ipsilateral TIA before CI were divided into two groups on basis of the duration of TIA(≤20 min,20 min). The score of neurologic impairment was rated according to modified Edinburgh-Scandina stroke scale when the patients were admitted to hospital and when course two weeks, meanwhile compared infarction lesion volume.Results There were significant differences of scores of neurological deicits and infarction lesion volume in patients TIA≤20 min and patients without ipsilateral TIA before CI(P20 min(P20 min.Conclusion There are protective effects of transient ischemic attack on subsequent cerebral infarction, and the ischemia time is limited.? 　　【Key words】 Transient; Ischemic attack; Brain infarction; Time 　　 　　短暂性脑缺血发作(transient ischemic attack,TIA)是指由于某种因素造成的脑动脉一过性或短暂性供血障碍，导致相应供血区局灶性神经功能缺损或视网膜功能障碍。TIA是脑梗死的前兆，同时又是脑梗死的重要危险因素。目前在动物脑缺血模型中发现一种脑缺血耐受现象［1］，即先前的脑缺血对后继的脑梗死具有保护性作用，有学者开始研究人类是否也具有脑缺血耐受现象。在临床上，TIA可能代表一个脑缺血预处理模型。我们通过分析我院收治的脑梗死患者，探讨TIA对后继脑梗死是否有保护作用。? 　　1 资料与方法? 　　1.1 研