The Risk Factor Analysis And Prognosis Of Minor Stroke And Normal Stroke

Objective:Because of TIA and minor stroke patients have a high-risk of vascular events, especially those who don’t want to accept treatment of tissue plasminogen activator because the minor stroke only cause slight symptoms should receive more attention. Used minor stroke(NIHSS≤3 or TIA) [0.5] as a mild symptom stroke pattern hasn’t received a widely attention,this study compared minor stroke with normal stroke about the risk of recurrence, and discussed the risk factors associated with the prognosis of minor stroke, to cause the attention of clinicians to minor stroke.Methods:We included 560 patients with anterior circulation stroke, which 293 patients show minor stroke(NIHSS ≤3 points); 267 patients were performed as a normal stroke(NIHSS > 3points). They were studied by history- taking, blood pressure, diabetes, atrial fibrillation,coronary heart disease, smoking history, alcoholism, blood fat and blood homocysteine levels;and the patients should complete the head magnetic resonance imaging(MRI), transcranial vascular ultrasound(CA) and neck vascular colour to exceed(TCD) examination within 72 hours. Evaluate the collateral circulation with CA and TCD. After discharge, we did the telephone follow-up on January 1, 2016 to January 7, inquiry their living conditions and recurrent situation and evaluation points of MRS. Using statistical methods to analyze the relationship between the patient risk factors and prognosis, comparing the difference between the minor group and normal group.Results:There is no significant different between the two group in this risk factors, such as hypertension, diabetes, coronary heart disease, smoking history, alcoholism, high cholesterol and high homocysteine levels. In age(minor stroke average 57.22 + 12.29,normal stroke average 59.02 + 11.02, P = 0.028 < 0.05), atrial fibrillation(3.8% of minor stroke, normal stroke 7.9%, P = 0.036 < 0.05), lesion related vascular stenosis(minor stroke 37.6%, normal stroke 57.5%, P < 0.001), collateral circulation(minor stroke 8.0%, normal stroke 14.9%, P <0.05), the initial infarction location, etc. are different. Minor stroke infarction is easier toisolated cortical or deep Department of white matter infarction(P < 0.05), while the normal stroke patients the lesion is more likely to occur in the cortex with or without cortex and deep white matter(P < 0.05).Minor stroke patients with atrial fibrillation or carotid artery stenosis or occlusion had worse outcomes with significant difference(P < 0.05). There was no difference in the recurrence rate of patients with minor stroke compared with those with normal stroke(mild stroke recurrence 10.6%, non mild stroke recurrence 10.9%, P=0.914 > 0.05). Minor stroke compliance with prescribed medication was lower than that of normal stroke patients(minor stroke 41.8%, normal stroke 55.6%, P < 0.001).Conclusions:The difference between minor stroke and normal stroke were mainly in the younger age,fewer atrial fibrillation, lighter vascular stenosis, worse establishment of collateral circulation,difference of the initial infarct site and so on. The recurrence rate of patients with minor stroke was not lower than that in patients with normal stoke, and patients with atrial fibrillation and severe stenosis carotid artery had worse prognosis and pay less attention to medical advice. Patients with minor stroke should also take more clinical attention and do active second prevention.