Geçici iskemik ataklı hastaların epidemiyolojik özellikleri, kısa ve uzun dönem inme gelişimi üzerine etki eden faktörler
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Dosyalar
Tarih
2010
Yazarlar
Dergi Başlığı
Dergi ISSN
Cilt Başlığı
Yayıncı
Trakya Üniversitesi Tıp Fakültesi
Erişim Hakkı
info:eu-repo/semantics/openAccess
Özet
İnme, dünyada üçüncü sıradaki ölüm nedeni olup endüstrileşmiş toplumlarda, hastane başvurularında ve sağlık harcamalarında önemli bir yer tutmaktadır. Primer önleme özellikle önemlidir, çünkü vakaların %70'i ilk olaydır (104). Etkili önleyici yaklaşımlar ile yaşa spesifik insidansı son 20 yıl içinde %40 azaltılmıştır. İnmeye bağlı sakatlıklar, hastaların yaşam kalitesini düşürmekte ve yaşamlarını yakınlarına bağımlı olarak sürdürmelerine neden olmaktadır. Özellikle kardiyovasküler hastalık ve iskemik inme için yüksek riske sahip olan Geçici İskemik Atak'ın çoğunlukla ilk başvuru yeri olan acil servislerde hızlı tanı ve tedavisi gerekmektedir. Bizim çalışmamızda amacımız acil servise başvuran, Geçici İskemik Atak tanısı alan hastaların yakın dönem inme gelişimi üzerine etki eden risk faktörleri ve yakın dönem inme riskini belirlemektir. Trakya Üniversitesi Tıp Fakültesi Nöroloji Anabilim Dalı'nda gerçekleştirilen bu çalışmaya toplam 54 hasta alındı. Bu 54 hastanın 16'sı kadın, 38'i de erkek olup, kadınların yaş ortalaması 67.50 ± 8.69 ve erkeklerin yaş ortalaması 67.55 ± 10.11 ve cinsiyetten bağımsız olarak bütün vakaların yaş ortalaması 67.54 ± 9.63'tü. Hastaların 10 (%18.5)'unda diyabetes mellitus, 33 (%61.1) hipertansiyon en fazla görülen risk faktörüydü. ABCD2 puanının (4.57/3.98) (p=0.202), geliş kan şekerinin (139.33/119.17) (p=0.264), Geçici İskemik Atak süresinin (36.14/98.00) (p=0.351), total kolesterol değerinin (167.57/172.57) (p=0.694), LDL değerinin (109.86/110.32) (p=0.969), hipertansiyon (p=0.548) ve diyabetes mellitus (p=0.337), diffüzyon manyetik rezonans görüntüleme bulgusu (+) (p=0.169) ve karotis arter stenozunun (p=0.146) inme gelişimi üzerine etkisinin olmadığı bulundu. Geliş sistolik (p=0.028) ve diastolik (p=0.016) kan basıncının inme gelişimi riskini önemli derecede arttırdığı bulundu. Sonuçta: ABCD2 puanı, geliş kan şekeri değeri, Geçici İskemik Atak süresi, total kolesterol ve LDL değeri hipertansiyon ve diyabetes mellitus varlığı, difüzyon manyetik rezonans görüntülemede lezyon varlığı ve karotis stenozu ile inme gelişimi arasında bir ilişkinin olmadığı, geliş sistolik ve diastolik kan basıncı değerinin 140/90 mmHg üzerinde olmasının Geçici İskemik Atak sonrası inme gelişimi üzerine belirgin etkisi olduğu bulundu. Anahtar kelimeler: Geçici iskemik atak, inme, karotis stenozu.
Abstract
Stroke is worlds third ranked cause of death in industrialized societies, an important role in hospitals applications and healthcare expense. Primary prevention is particularly important, because 70% of the cases are the first event (104). Effective preventive approaches reduced 40% of the age specific incidence in the last 20 years. Disabilities due to stroke, reduce the life quality of patients and patients dependent on their relatives for continuing their lives. Transient İschemic Attack has especially high risk for cardiovascular disease and ischemic stroke. Usually they first consult to emergency departments and rapid diagnosis and treatment is required at there. The aim of our study, to determine development of the near-term effect of stroke risk factors and the near-term risk of stroke of patients whom Transient İschemic Attack diagnosed at consultation in our emergency department . This study performed at the Trakya University Faculty of Medicine Neurology Department and 54 patients were included in this study. 32 of 54 patients were male and 12 of patients were female. Females mean age were 67.50 ± 8.69 and males mean age were 67.55 ± 10.11 and the average age in all cases regardless of sex was 67.54 ± 9.63. 10(18%) of Patients have most common risk factor for diabetes mellitus was and for hypertension it was 33(61.1%). We found that ABCD2 score (4.57/3.98) (p=0.202), arrival blood sugar (139.33/119.17) (p=0.264), duration of Transient İschemic Attack (36.14/98.00) (p=0.351), total cholesterol value (167.57/172.57) (p=0.694), LDL value (109.86/110.32) (p=0.969), hypertension (p=0.548) and diabetes mellitus (p=0.337), diffusion weighted magnetic resonance imaging findings (+) (p=0.169) and carotid artery stenosis (p=0.146) has no effect on the development of stroke. Arrival systolic (p=0.028) and diastolic (p=0.016) blood pressure was found to increase significantly the risk of developing stroke. The result: ABCD2 score, incidence of blood glucose value, duration of Transient İschemic Attack, the value of total cholesterol and LDL value, presence of hipertension and diabetes mellitus, diffusion weighted magnetic resonance imaging lesion and carotid stenosis has no relationship with the development of stroke. We found that arrival systolic and diastolic blood pressure value being over 140/90 mmHg has no significant effect on the development of stroke after Transient İschemic Attack. Key words: Transient ischemic attack, stroke, carotid stenosis.
Abstract
Stroke is worlds third ranked cause of death in industrialized societies, an important role in hospitals applications and healthcare expense. Primary prevention is particularly important, because 70% of the cases are the first event (104). Effective preventive approaches reduced 40% of the age specific incidence in the last 20 years. Disabilities due to stroke, reduce the life quality of patients and patients dependent on their relatives for continuing their lives. Transient İschemic Attack has especially high risk for cardiovascular disease and ischemic stroke. Usually they first consult to emergency departments and rapid diagnosis and treatment is required at there. The aim of our study, to determine development of the near-term effect of stroke risk factors and the near-term risk of stroke of patients whom Transient İschemic Attack diagnosed at consultation in our emergency department . This study performed at the Trakya University Faculty of Medicine Neurology Department and 54 patients were included in this study. 32 of 54 patients were male and 12 of patients were female. Females mean age were 67.50 ± 8.69 and males mean age were 67.55 ± 10.11 and the average age in all cases regardless of sex was 67.54 ± 9.63. 10(18%) of Patients have most common risk factor for diabetes mellitus was and for hypertension it was 33(61.1%). We found that ABCD2 score (4.57/3.98) (p=0.202), arrival blood sugar (139.33/119.17) (p=0.264), duration of Transient İschemic Attack (36.14/98.00) (p=0.351), total cholesterol value (167.57/172.57) (p=0.694), LDL value (109.86/110.32) (p=0.969), hypertension (p=0.548) and diabetes mellitus (p=0.337), diffusion weighted magnetic resonance imaging findings (+) (p=0.169) and carotid artery stenosis (p=0.146) has no effect on the development of stroke. Arrival systolic (p=0.028) and diastolic (p=0.016) blood pressure was found to increase significantly the risk of developing stroke. The result: ABCD2 score, incidence of blood glucose value, duration of Transient İschemic Attack, the value of total cholesterol and LDL value, presence of hipertension and diabetes mellitus, diffusion weighted magnetic resonance imaging lesion and carotid stenosis has no relationship with the development of stroke. We found that arrival systolic and diastolic blood pressure value being over 140/90 mmHg has no significant effect on the development of stroke after Transient İschemic Attack. Key words: Transient ischemic attack, stroke, carotid stenosis.
Açıklama
Tıpta Uzmanlık Tezi
Anahtar Kelimeler
Nöroloji, Neurology, Geçici İskemik, Atak, İnme, Karotis Stenozu, Transient Ischemic Attack, Stroke
