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目的 了解短暂性脑缺血发作(TIA)患者的脑血管病变基础,探索TIA的治疗方法。方法 对20例TIA患者行全脑血管造影,了解血管病变的情况。针对其中18例显示有脑血管动脉硬化斑块造成血管管腔狭窄或大脑半球普遍供血不良的患者行尿激酶动脉溶栓治疗。并进行随访观察。结果 在20例TIA患者中大脑半球供血减少2例,大脑中动脉狭窄11例,颈内动脉狭窄5例(合并大脑前动脉狭窄、椎动脉狭窄各1例),未见血管异常影象2例。18例溶栓治疗后脑血流明显改善3例,好转13例,无明显改善2例。溶栓治疗后3例分别在溶栓后立即,16天,1个月后再次TIA发作。TIA再发作与用药量和溶栓后血流改善程度无关。随访3～22个月未见发生脑梗塞者。结论 多数对TIA患者已有脑血管器质性病变,应尽早行有效治疗。
Objective To understand the basis of cerebrovascular disease in patients with transient ischemic attack (TIA) and to explore the treatment of TIA. Methods Twenty patients with TIA underwent total cerebral angiography to understand the vascular lesions. 18 patients with cerebrovascular atherosclerotic plaque showed vascular stenosis or poor blood supply to the general cerebral hemisphere in patients with urokinase arterial thrombolysis. And follow-up observation. Results In 20 TIA patients, there were 2 cases of decreased hemispheric hemisphere, 11 cases of middle cerebral artery stenosis, 5 cases of internal carotid artery stenosis (1 case of anterior cerebral artery stenosis and 1 case of vertebral artery stenosis), and no abnormal vascular images . In 18 cases of thrombolytic therapy, cerebral blood flow was significantly improved in 3 cases, improved in 13 cases, no significant improvement in 2 cases. Thrombolytic therapy in 3 cases were immediately after thrombolysis, 16 days, 1 month after TIA attack again. TIA reoccurrence has nothing to do with the dose and blood flow improvement after thrombolysis. Follow-up 3 to 22 months no cerebral infarction occurred. Conclusion Most patients with TIA have cerebrovascular organic disease, effective treatment should be as soon as possible.