目的 探讨规范二级预防下老老年人轻型卒中复发的危险因素。方法 收集我院80岁及以上、既往有轻型卒中病史、并进行规范二级预防半年以上的老老年患者的临床资料:一般资料、既往病史及用药情况、入院时血压及基础生化指标、影像学资料、缺血性卒中复发情况。根据有无复发缺血性卒中将患者分为复发组和无复发组两组,分析以上因素在两组间的差异。结果 80例患者中复发缺血性脑卒中共26例,复发率32.5%。统计结果显示,轻型卒中复发组与合并高血压病、入院时收缩压、D二聚体水平呈正相关,其相关系数分别为0.265(P=0.018)、0.232(P=0.038)和0.222(P=0.048)。复发组收缩压升高比例高于无复发组(χ²=6.919,P=0.031)。非条件Logistic多因素分析显示:合并高血压病[OR 95%CI=(1.162,10.230)]、收缩压升高[OR 95%CI=(0.997,68.840)]与轻型缺血性卒中复发相关。结论 合并高血压病、收缩压升高是老老年人轻型卒中规范二级预防下复发独立危险因素。

Objective To analyze the recurrence risk factors of aged patients with minor ischemic stroke under standardized secondary prevention. Methods Patients over 80 years old and with minor ischemic stroke history were enrolled, and the following data were collected: demographic characteristics, medical history, current medicine, blood test, imaging findings and recurrence of ischemic strokes. Patients were divided into two groups: the recurrence group and the non-recurrence group. Chi-square test,logistic regression models were performed to assess correlations between baseline variables and recurrence of minor stroke events. Results In our study, 26 patients had recurrent minor ischemic stroke(32.5%). The prevalence of recurrence of minor stroke was positively correlated with hypertension(CI 0.265, P 0.018), SBP(CI 0.232,P 0.038), d-2-dimer(CI 0.232,P 0.048). Patients in recurrence group are more likely to presented with SBP elevation compared to non-recurrence group(χ²=6.919, P=0.031). Unconditional logistic regression analysis showed that hypertension, especially high SBP significantly related to minor ischemic stroke recurrence. Conclusion Hypertension,especially elevated SBP, were considered as an independent risk factors for aged old patients with minor ischemic stroke who received standardized secondary prevention.

目的 探讨脊髓小脑性共济失调一家系的临床表现、影像学特点和基因型及三者之间的联系。方法 描述一家系5例患者的临床表现,总结其特点,对部分患者行头颅磁共振及基因检测。结果 一家系4代7名成员中共有5例发病,以行走不稳和言语含糊为突出表现,头颅MRI示小脑萎缩,基因检测SCA3相关基因的CAG重复数为65次,确诊为SCA3。结论 SCAs为一组神经系统遗传性疾病,临床以共济失调和构音障碍为突出表现,基因检测可为临床提供准确的分型。

Objective To explore the relation of clinical manifestation, MRI and gene data with the spinocerebellar ataxia. Methods To give a description of the clinical manifestation of the spinocerebellar ataxia patients, summarize the characteristics, and part of them to make the MRI and genetic detection. Results There are 5 patients among 7 numbers of 4 generations in the family.The main clinic features included gait ataxia and ambiguity in speech. Brain MRI showed atrophy on cerebellum. The repeated times of CAG of SCA3 were 65, diagnosed as SCA3 patient. Conclusion SCAs is one group of genetic diseases. The clinical manifestations are ataxia and dysarthria. Molecular genetic detection can be used for SCA subtype diagnosis.