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中青年 TIA 和缺血性卒中患者的危险因素及检查比较。

Comparison of risk factors and work-up in young and middle-aged patients with TIA and ischaemic stroke.

机构信息

Department of Neurology, Rambam Health Care Campus, Technion Faculty of Medicine, Haifa, Israel.

出版信息

Eur J Neurol. 2010 Apr;17(4):567-71. doi: 10.1111/j.1468-1331.2009.02857.x. Epub 2009 Nov 18.

DOI:10.1111/j.1468-1331.2009.02857.x
PMID:19922452
Abstract

BACKGROUND

The transient ischaemic attack (TIA) is accepted as a subtype of resolved ischaemic stroke. In that case, the risk factor profiles as well as the work-up results of TIA and stroke patients should be similar in both groups. Given that such data are limited, we compared the risk factor profiles and work-up results in young and middle-aged patients with TIA and ischaemic stroke.

PATIENTS AND METHODS

Data on 167 TIA patients and 489 stroke patients aged <or=60 were compared for risk factor profiles, work-up results, and pre- and post-event treatment regimens.

RESULTS

The only difference found between the groups in the distribution of vascular risk factors was a significantly higher prevalence of diabetes in the stroke group (P = 0.02). There were no differences found between the two groups in the distributions of carotid and aortic plaques, carotid stenoses and occlusion, homocysteine levels, or frequencies of patient foramen ovale by echocardiography. The levels of cholesterol and triglycerides, as well as abnormal brain CT, were higher in the stroke group, both before and after adjustment. There was no difference found in any compared parameter of treatment between the TIA and the stroke patients.

CONCLUSIONS

The risk factor profiles and the work-up results are similar between the TIA and the stroke patients. These findings highlight the etiologic homogeneity of both conditions; therefore, justify their uniform management. In addition, low yield of CT in TIA patients was found, questioning thus the routine use of CT in work-up of TIA.

摘要

背景

短暂性脑缺血发作(TIA)被认为是缺血性中风的一个亚型。在这种情况下,TIA 和中风患者的危险因素谱以及检查结果应该在两组中相似。鉴于此类数据有限,我们比较了年轻和中年 TIA 和缺血性中风患者的危险因素谱和检查结果。

患者和方法

比较了 167 例 TIA 患者和 489 例年龄<或=60 岁的中风患者的危险因素谱、检查结果以及事件前后的治疗方案。

结果

两组血管危险因素的分布只有一个差异,即中风组的糖尿病患病率明显较高(P=0.02)。两组之间颈动脉和主动脉斑块、颈动脉狭窄和闭塞、同型半胱氨酸水平或经超声心动图发现卵圆孔未闭的患者频率没有差异。中风组的胆固醇和甘油三酯水平以及异常的脑 CT 在调整前后均较高。TIA 和中风患者之间任何比较参数的治疗均无差异。

结论

TIA 和中风患者的危险因素谱和检查结果相似。这些发现强调了这两种情况的病因同质性;因此, justifies 它们的统一管理。此外,还发现 TIA 患者 CT 的检出率较低,因此质疑 CT 在 TIA 检查中的常规使用。

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