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背景:短暂性脑缺血发作(transientischemicattacks,TIA)是脑梗死的高危因素。动物实验表明,短暂性的非致命的脑缺血又可产生“缺血耐受”现象。对此,临床研究较少。目的:探讨预先的TIA对后继脑梗死是否有保护作用。设计:以诊断为依据的回顾性对照研究。地点、对象和方法:病例来源于1998-06/2001-09西安交通大学第二医院神经内科和老年病科住院的脑梗死患者,从1006例中选择病程超过1个月者673例,按照预先是否发生同侧的TIA及其持续时间分为TIA短于20min组,TIA20～60min组和无TIA组,并于病程1个月时对各组患者进行生活能力评分,评定预后,分析预后与TIA持续时间、发作次数及首次TIA与脑梗死间隔时间的关系。主要观察指标:①各组脑梗死患者恢复情况。②TIA发作次数与脑梗死预后关系。③首次TIA发作距脑梗死出现间期与脑梗死临床预后关系。结果:脑梗死前有同侧TIA发作,且TIA<20min时、Ⅰ级预后所占比例(72%,36/50)明显多于TIA20-60min者(54%,12/22)和无TIA者(53%,313/591),但仅与后者有显著性差异(χ2=6.75,P<0.01);脑梗死前同侧的TIA发作2或3次者,Ⅰ级预后比例(72%,26/36)较高,与无TIA者有显著性差异(χ2=5.07,P<0.05);同侧的TIA发作与脑梗死间隔在1周内者,Ⅰ级预后比例明显高于无TIA组(χ2=5.48,P<0.05)。?
Background: Transient ischemic attacks (TIA) are risk factors for cerebral infarction. Animal experiments show that transient non-fatal cerebral ischemia can produce “ischemic tolerance” phenomenon. In this regard, less clinical research. Objective: To investigate whether pre-TIA has protective effect on subsequent cerebral infarction. Design: A retrospective, controlled, controlled study. Location, Subjects and Methods: The cases were from the patients with cerebral infarction hospitalized in Department of Neurology and Geriatrics, Second Hospital, Xi’an Jiaotong University from June 1998 to September 2001. 673 patients with disease duration of more than 1 month were selected from 1006 patients. Whether the occurrence of ipsilateral TIA and its duration were divided into TIA less than 20min group, TIA20 ~ 60min group and no TIA group, and in the course of 1 month, the patients in each group were assessed for life ability, prognosis, prognosis and TIA Duration, the number of seizures and the relationship between the first TIA and cerebral infarction time interval. MAIN OUTCOME MEASURES: ① The recovery of patients with cerebral infarction in each group. ② the number of TIA seizures and prognosis of cerebral infarction. The relationship between the first TIA onset and the clinical prognosis of cerebral infarction. Results: The incidence of ipsilateral TIA before cerebral infarction was significantly higher than that of TIA 20-60min (54%, 12/22) and no TIA at TIA <20min (72%, 36/50) (53%, 313/591), but only with the latter significant difference (χ2 = 6.75, P <0.01); cerebral infarction ipsilateral TIA attack 2 or 3 times, Ⅰ grade prognosis (72% (Χ2 = 5.07, P <0.05). The proportion of patients with ipsilateral TIA attack within one week after cerebral infarction was significantly higher than those without TIA (χ2 = 5.48, P <0.05). ?