应用ABCD2评分预测短暂性脑缺血发作后短期卒中事件发生风险

目的:探讨ABCD2评分对短暂性脑缺血发作(TIA)后7 d内发生脑梗死(CI)的预测价值。方法:纳入115例TIA患者,依据发病7 d内是否发生CI,分为CI组33例和非CI组82例。记录所有纳入对象的脑血管病相关危险因素及ABCD2评分。应用单因素及多因素分析分析2组间相关危险因素及ABCD2评分的差异性。应用受试者工作曲线(ROC)分析ABCD2评分预测TIA后7 d内发生为CI的预测价值。结果:CI组年龄、ABCD2评分均高于非CI组,差异有统计学意义(P<0.05或P<0.01)。单因素分析结果表明,CI组中年龄≥60岁、收缩压≥140 mmHg和(或)舒张压≥90 mmHg、单侧肢体无力、症状持续≥60 min的患者比例均高于非CI组,差异有统计学意义(均P<0.05),CI组中症状持续10~59 min的患者比例低于非CI组,差异有统计学意义(P<0.05)。多因素分析结果表明,CI组中年龄≥60岁、收缩压≥140 mmHg和(或)舒张压≥90 mmHg、症状持续≥60 min的患者比例亦均高于非CI组,差异有统计学意义(均P<0.05)。ROC分析表明,以ABCD2评分=4.5分作为预测TIA短期发生为CI的界点,其灵敏度为57.6%,特异度为78.0%,曲线下面积为0.73。结论:ABCD2是一种预测TIA短期发生CI的简单、有效的工具,ABCD2评分≥5分对预测TIA短期发生CI可能有重要价值。

Clinical Application of ABCD2 Score in Predicting Evolution of Transient Ischemic Attack into Cerebral Infarction

ObjectiveTo explore the clinical efficacy of ABCD2 score in predicting transformation of transient ischemic attack （TIA） into cerebral infarction （CI） within 7 days. Methods：According to occurrence of CI 7 days after TIA, 115 TIA patients were divided into CI group （n=33） and non-CI group （n=82）. Risk factors of cerebrovascular diseases and ABCD2 scores were documented. Single factor and multivariate analysis have been used to explore the differences in risk factors and ABCD2 score contents between the two groups. Receiver operating characteristic curve （ROC） analysis was used to explore the efficacy of ABCD2 score as well. Results：The age and ABCD2 score in the CI group were significantly higher than those in the non-CI group P〈0.05 orP〈0.01）. On single factor analysis showed that, in the CI group, the proportion of patients older than 60 years, sys-tolic blood pressure higher than 140 mmHg and/or diastolic pressure higher than 90 mmHg, unilateral limb force weak, duration of symptoms longer than 60 min were significantly higher than that in the non-CI group（ P〈0.05）. In addition, in the CI group, the proportion of patients whose symptoms persisted for 10-59 min was much less than that in the non-CI group （P〈0.05）. Multivariate analysis showed the same results. ROC analysis showed that ABCD2 score of 4.5 was promised point in predicting TIA evolving into CI within short-term. The area under curve was 0.73 with sensitivity of 57.6%and specificity of 78.0%, Conclusion：ABCD2 score was a simple and effective tool to predict whether TIA will evolve into CI in short-term. ABCD2 score above 5 might have an im-portant predictive value.