ABCD2评分结合hs-CRP对短暂性脑缺血发作后发生脑梗死的评估价值

目的 探讨短暂性脑缺血发作（transient ischemic attack,TIA）患者ABCD2评分与血清超敏C反应蛋白（hs-CRP）水平的关系,及ABCD2评分法预测TIA进展为脑梗死的价值.方法 测定79例TIA患者（TIA组）和40例健康体检者（对照组） 血清hs-CRP水平,TIA组按ABCD2评分分为高危组、中危组和低危组,比较3组间hs-CRP水平,并观察其2 d、7 d内脑梗死的发生率.结果 TIA组血清hs-CRP水平高于对照组（P〈0.05）;高、中、低危组间血清hs-CRP水平差异均有统计学意义（P〈0.05）,评分≤3分的TIA患者22例,2 d、7 d发生脑梗死分别为1例（4.5%）、2例（9.1%）;评分为4或5分的患者31例,2 d、7 d进展为脑梗死分别为3例（9.7%）、5例（16.1%）;评分≥6分的患者26例,2 d、7 d进展为脑梗死分别为7例（26.9%）、10例（38.5%）.不同ABCD2评分值的TIA患者,其脑梗死发生率差异均有统计学意义（P均〈0.05）.结论 TIA患者ABCD2评分与血清hs-CRP水平关系密切,两者呈正相关.ABCD2评分值不同,脑梗死的发生率不同,分值越高,发生率越高,联合二者更有助于TIA的指导治疗和风险评估.

The value of combined ABCD2 score and high-sensitivity C-reactive protein in evaluating cerebral infarction after a transient ischemic attack

Objective To explore the relationship between the serum high-sensitivity C-reactive protein（hs-CRP） levels and ABCD2 score in transient ischemic attack （TIA） patients, and to investigate the value of the ABCD2 score in forecasting the risk of stoke after TIA. Methods The levels of serum hs-CRP were measured at admission in 79 patients with TIA and 40 age-matched healthy persons. Patients with TIA were classified as high-risk group, middle-risk group and low-risk group ac- cording to the ABCD2 score. The serum hs-CRP levels within three groups were compared separately, and the incidence of cere- bral infarction was observed within 2 and 7 days after the presence of TIA. Results The levels of serum hs-CRP in TIA pa- tients were higher than those in healthy persons （P〈0.05）. The statistical difference occured all the hs-CRP levels within three groups （P〈0.05）. Of the 22 TIA patients whose score was less than 4, 1 had a stroke within 2 days （4.5%）, and 2 within 7 days （9.1%）. Of the 31 patients with a score of 4 or 5, 3 had a stroke within 2 days （9.7 %）, and 5 within 7 days （16.1%）. Of the 26 patients at high risk with a score of greater than 5, 7 had a stroke within 2 days （26.9%）, and 10 within 7 days （38.5 %）. The incidence of cerebral infarction of TIA patients with a different score had significant differences（P〈0.05）. Con- clusion There was positive correlation between ABCD2 score and hs-CRP levels in TIA patients, Incidence of cerebral infarc- tion within 2 and 7days after presence of TIA correlated to the ABCD2 score. The higher the score, the higher the inci- dence. Both of them are very useful to guide treatment and to evaluate risk for TIA patients.