【摘要】 目的对比高龄及中低龄老年短暂性脑缺血发作(TIA)/轻型卒中患者的临床特点及预后。方法收集2009年4月至2016年12月在江苏省人民医院老年神经科收治的老年TIA/轻型卒中患者232例,其中高龄(≥80岁以上)患者103例,中低龄老年(≥60岁且<80岁)患者129例。比较高龄组和中低龄老年组以及预后良好组与预后不良组患者间临床特点差异,采用多因素Logistics回归分析影响高龄与中低龄老年TIA/轻型卒中患者预后的影响因素。结果与中低龄老年组相比,高龄组的卒中史、冠心病、房颤、痴呆、卒中后肺炎的比例以及预后不良的发生率明显较高(P<0.05)。多因素分析显示,年龄≥80岁是TIA/轻型卒中预后不良的独立危险因素(OR=2.829,P=0.005)。NIHSS评分、卒中后肺炎、冠心病是高龄患者预后不良的独立危险因素(OR=1.607,P=0.007;OR=7.190,P=0.001;OR=3.153,P=0.026),NIHSS评分、卒中后肺炎、神经功能进展是中低龄老年患者预后不良的独立危险因素(OR=2.262,P=0.000;OR=4.341,P=0.023;OR=3.192,P=0.033)。结论高龄TIA/轻型卒中患者更易合并心脑血管基础病及痴呆,临床预后更差,有部分患者将面临致残的结局。更多还原

【Abstract】 Objective To compare the characteristics and outcomes of the very old and young-old patients with TIA/minor stroke.Methods 232 old patients with TIA/minor stroke were admitted to the Department of Geriatrics,Jiangsu Province Hospital.They were collected and divided into a very old group(aged 80 years and above,n=103)and a young-old group(60-79 years old,n=129).We analyzed the characteristics and outcomes of the patients.Results Compared with the young-old group,the very old patients were more likely to have histories of stroke,coronary heart disease,atrial fibrillation and dementia(P<0.05). Pneumonia after stroke was more frequent in the very old group(P<0.05).At 30 days after stroke,the very old patients were more likely to have a bad outcome(P<0.05).After multivariate analyses,aged 80 years and above was shown to be an independent risk factor for bad outcome(OR=2.829,P=0.005).NIHSS score,pneumonia and coronary heart disease were risk factors for bad outcome in the very old group(OR=1.607,P=0.007;OR=7.190,P=0.001;OR=3.153,P=0.026).NIHSS score,pneumonia and neurological deterioration were risk factors for bad outcome in the young-old group(OR=2.262,P=0.000;OR=4.341,P=0.023;OR=3.192,P=0.033).Conclusions The very old TIA/minor stroke patients are more likely to have vascular conditions and dementia.Their clinical outcome is worse than the younger patients.Some of them may be functionally dependent after stroke.更多还原