摘要
目的 观察短暂性脑缺血发作 (TIA)患者首次TIA后TIA的复发、完全性卒中与心肌梗死的发生以及生存情况 ,并探讨TIA患者行神经血管外科手术的临床价值。 方法 对 72例TIA患者进行面对面的随访 ,以首次TIA发作为起点 ,到最后一次随访 (1998年 )止。结合前 3次随访资料进行分析 ,并依据寿命表原理对随访资料进行生存分析。 结果 总的TIA复发率为 2 7 9% ,首次完全性卒中的发生率为 6 5 7% ,心肌梗死的发生率为 8 4% ,病死率为 72 7%。主要死亡原因为完全性卒中 ,占所有死亡患者的 5 9 6 % ,其中非老年患者的首位死亡原因为脑出血 ,老年患者的首位死亡原因为脑梗死。致死性心肌梗死患者 2例 ,占死亡患者的 3 8%。满 2 0年的生存率为 39 9% ,其 95 %可信区间为 (2 8 4% ,5 1 4% )。有神经血管外科手术指征的患者 19例 ,占所有患者的 2 6 6 %。 结论 首次TIA后约有近 1/3TIA患者出现TIA复发 ,完全性卒中的发生率明显高于心肌梗死的发生率。主要死亡原因为完全性卒中而非心肌梗死。
Objective In order to observe the long term follow up of 72 patients with transient ischemic attack(TIA),including the recurrence of TIA after the first attack, occurrence of complete stroke and myocardial infarction, fatality rate, causes of death, and the survival rate in each year and its 95% confidence interval, and to evaluate the clinical significance of neurovascular surgical indication. Methods Seventy two patients with TIA collected from 1959 to 1977 were followed up by means of face to face communication with the patients themselves or their families till 1998. And those aspects mentioned above were analyzed with the methods of cohort study, life table and other medical epidemiological statistics. Results The recurrent rate of TIA in 72 patients was 27 9%, and the occurrence rate of complete stroke 65 7%, and that of the myocardial infarction and the fatality 8 4% and 72 7%, respectively. There were 2(3 8%) patients died of myocardial infarction. It was showed from the study that the main cause of death was complete stroke, accounting for 59 6% of all dead patients, with the first cause in non elderly patients was cerebral hemorrhage and that in the elderly patients was cerebral infarction. The 20 year survival rate was 39 9% and its 95% confidence interval was (28 4%,51 4%). Nineteen cases had the indication of neurovascular surgical operation, accounting for 26 6% of all 72 patients. Conclusions In the long term follow up study, the prognosis of patients with TIA was better than that of those with cerebral infarction. About one third of patients had the recurrence of TIA. The occurrence rate of the complete stroke was obviously higher than that of the myocardial infarction. It was considered that neurovascular surgical operation for preventing the happening of complete stroke in patients with TIA was limited.
出处
《中华老年医学杂志》
CAS
CSCD
北大核心
2001年第2期85-88,共4页
Chinese Journal of Geriatrics
