The Analysis Of Related Factors Of Cerebral Infarction After Transient Ischemic Attack

Objective: Analyze and compare epidemiological characteristics, clinical symptoms, related blood tests, intracranial vascular checks and other factors of the patients of cerebral infarction after TIA and TIA to find out the reason of progression of early TIA to infarction, in order to be helpful for future clinical work.Methods:Collected329patients with transient ischemic attack as clinical manifestations which treated in tianjin huanhu hospital from January2012to November2013, in which176cases are TIA patients as TIA group, and153cases progress to infarction as cerebral infarction group.Analysis and compare clinical symptoms, related blood tests, intracranial vascular examination and ABCD2score of the two groups to understand the risk factors for early progression of TIA to cerebral infarction.Results:In two groups,39cases(22.16%) of TIA group have a history of diabetes, and50cases(32.68%) of CI group have the history, P<0.05,which is associated with cerebral infarction after TIA; The patients whose symptom duration>30minutes are41cases(23.30%)in TIA group, and seizure frequency≥4times are71cases(40.34%), while the ones whose symptoms duration>30minutes are64cases (41.83%) in CI group,and seizure frequency≥4times are80cases(52.29%), OR were1.512and1.786, P<0.05, which are associated with the progess of TIA to cerebral infarction; The patients whose systolic blood pressure<140mmHg at admission in the TIA group are78cases (44.32%), and≥180mmHg are12cases (6.82%), while <140mmHg are34cases (22.22%), and≥180mmHg are30cases (19.61%) in the CI group. Systolic blood pressure of the patients in CI group is significantly higher than that in TIA group, OR1.613, P<0.05, which is significantly correlated; In the related blood tests,the hs-CRP OR1.475, P<0.05,which is significantly correlated with the progression of TIA to infarction;In neck vascular ultrasound examination, TIA group found328plaques,in which the unstable plaques are152(46.34%),while CI group found364plaques, in which the unstable plaques are208(57.14%).the proportion of unstable plaques in the patients of CI group is significantly higher. TIA group found28patients with a total of43cervical stenosis, in which mild stenosis are23(53.49%), moderate stenosis are11(25.58%),and severe stenosis or occlusion are9(20.93%),while CI group found46patients with a total of74cervical stenosis, in which mild stenosis are28(37.84%),moderate stenosis are14(18.92%),and severe stenosis or occlusion are32(43.24%).In two groups, the proportions of patients with cervical stenosis and severe stenosis or occlusion in cerebral infarction group are all significantly higher than those in TIA group. In MRA, the two groups are given priority to intracranial vascular and anterior circulation stenosis,while in TIA group the mild stenosis are79(59.85%), moderate stenosis are26(19.70%), and severe stenosis are27(20.45%);In CI group mild stenosis are94(47.47%), moderate stenosis are35(17.68%),and severe stenosis are69(34.85%).The proportion of moderate to severe cerebral artery stenosis in CI group is significantly more than those in TIA group, P<0.05, the difference is statistically significant. In the TIA group ABCD2score0-3are81cases (46.02%),4-5are85cases (48.30%),and6-7are10cases (5.68%),while0-3are48cases (27.27%),4-5are78cases(50.98%),and6-7are27cases(17.65%) in CI group. The proportion of high-risk score in CI group is significantly greater than those in TIA group,which can predict the risk of stroke after TIA.Conclusion:history of diabetes, systolic blood pressure significant increase, TIA symptom duration>30minutes, the number of attacks>4times, hypersensitivity elevated c-reactive protein, unstable plaque in neck vascular ultrasound, Moderate to severe stenosis of intracranial vascular is an early risk factor for progression of TIA to infarction. ABCD2score≥4points can predict the risk of stroke after TIA.