短暂性脑缺血发作患者ABCD~2评分与磁共振弥散加权成像的相关性研究

目的研究ABCD~2评分结合磁共振弥散加权成像(diffusion-weighted imaging,DWI)对短暂性脑缺血发作(trsnsient ischemic attack,TIA)患者继发脑梗死的评估价值。方法选择TIA患者162例,根据ABCD~2评分分为低危组29例、中危组87例及高危组46例,又根据DWI结果分为DWI阳性组73例和DWI正常组89例。结合DWI检查结果和其他临床资料进行回顾性分析。结果与低危组比较,中、高危组7、30、90 d继发脑梗死明显增高,差异有统计学意义(P<0.01)。与DWI正常组比较,DWI阳性组TIA发作次数≥3次、症状持续时间≥1 h、失语和(或)运动障碍、心房颤动、纤维蛋白原、C反应蛋白以及中重度颈动脉狭窄明显增加,差异有统计学意义(P<0.05,P<0.01)。DWI阳性组7、30、90 d继发脑梗死较DWI正常组明显增高,差异有统计学意义(P<0.01)。结论 ABCD~2评分对预测TIA后继发脑梗死的风险有较高的准确性,结合DWI检查结果 ,对其风险的评估,将会进一步提高。

Correlation between ABCD2 score and magnetic resonance diffusion-weighted imaging in patients with transient ischemic attack

Objective To study the value of combined ABCD~2 score and magnetic resonance diffusion -weighted imaging(DWI) for the assessment of secondary cerebral infarction in patients with transient ischemic attack(TIA).Methods One hundred and sixty-two TIA patients were divided into low risk group(n = 29),moderate risk group(n = 87) and high risk group(n = 46) according to their ABCD~2 score.The patients were further divided into positive DWI group(n = 73) and negative DWI group(n=89) according to their DWI.Their DWI findings and other clinical data were retrospectively analyzed.Results The incidence of secondary cerebral infarction was significantly higher in moderate and high risk groups than in low risk group on days 7,30 and 90(P<0.01). The number of TIA was≥3 and the persistent symptom time was≥1 h in postive DWI group, which were higher than those in negative DWI group.The aphasia and(or) dyscienesia and atrial fibrillation were severer,while the serum fibrinogen and C-reactive proptein levels,the incidence of moderate and severe carotid artery stenosis and secondary cerebral infarction were significantly higher in postive DWI group than in negative DWI group on days 7,30 and 90(P<0.05,P< 0.01).Conclusion The accuracy of ABCD~2 score is rather higher for predicting cerebral infarction risk in TIA patients and can thus further improve the assessment of cerebral infarction risk when it is combined with the DWI findings.