老年椎动脉性眩晕发作24h内相关因素与预后的关系

目的　观察老年椎动脉性眩晕起病情况及危险因素。方法　按发作次数和半年内最终有无脑血栓形成划分为A组、B组和C组。比较三组起病24 h内血液生化指标和颈动脉超声检查结果。结果　A组24 h内的高敏C反应蛋白(hs CRP)、收缩压( SBP)、舒张压(DBP)、血糖( BS)、胆固醇(TC)、甘油三脂( TG)、颈总动脉血流阻力指数(CCARI)、颈内动脉血流阻力指数(ICARI)、斑块指数明显低于C 组(P< 0. 01, P< 0. 05), hs CRP、TG、CCARI、ICARI、斑块指数(plaque index)明显低于B组(P<0.01, P<0.05),B组hs CRP、DBP、BS明显低于C组,纤维蛋白原(FIB)、高密度脂蛋白(HDL C)、低密度脂蛋白(LDL C)、载脂蛋白B(Apo B)三组比较无明显差异(P>0.05)。应用Logistic回归分析显示其症状反复发作和脑血栓形成的相关危险因素为hs CRP、SBP、BS、TC、CCARI、ICARI和斑块指数。结论　hs CRP、SBP、BS、TC、CCARI、ICARI和斑块指数的升高,可能是颈动脉内斑块不稳定,易脱落的预警指标。

The correlation between prognosis and the related factors of transient ischemic attack of vertebrobasilar artery vertige in old patients in the first 24 hours

Objective To investigate the onset and risk factors of the transient ischemic attack of vertebrobasilar artery vertige in old patients. Methods Patients were divided into group A, group B, group C based on attack times of vertige and whether cerebral thrombosis was formed within half a year. Blood biochemistry index, blood pressure variation, carotid ultrasonic examination results in the first 24 hours were compared. Results High sensitive C-reactive protein (hs-CRP), systolic blood pressure (SBP), diastolic blood pressure(DBP), blood sugar(BS), cholesterol(TC), triglyceride(TG), common carotid artery resistance of group A index(CCARI), internal carotid artery resistance index(ICARI) and atherosis plaque index in the first 24 hours were significantly lower than those of group C (P<0.01, P<0.05), and hs-CRP, TG, CCARI, ICARI and plaque index of group A were significantly lower than those of group B (P<0.01, P<0.05), and hs-CRP, DBP, BS in B group were significantly lower than those of group C, but no significant difference was found in fibrinogen(FIB), high dense lipoprotein (HDL-C), low dense lipoprotein(LDL-C) and apolipoprotein B (Apo B) in the three groups (P>0.05). Logistic regression indicated that hs-CRP, DBP, BS, TC, CCARI, ICARI and plaque index were correlated with risk factors of the transient ischemic attack of vertebrobasilar artery vertige and cerebral thrombosis in old patients. Conclusion hs-CRP, SBP, BS, TC, CCARI, ICARI and plaque index elevation might be an early warning index for the unstability and easy drop of the carotid's plaque.