ABCD~2评分法对短暂脑缺血发作患者的卒中风险分析

目的探讨ABCD~2评分法对短暂脑缺血发作(TIA)患者短期内进展为脑梗死的预测价值。方法按照Johnston等[4-6]对TIA的ABCD~2评分标准,测定98例TIA患者的评分并危险分组,观察其2、7d内脑梗死的发生率,比较各危险组之间卒中率的差异,分析ABCD~2评分中预测因子的作用。结果评分≤3分的TIA患者有40例,2、7d发生脑梗死的例数分别为0例(0%)、2例(5%);评分为4~5分的患者46例2、7d进展为脑梗死的例数分别为4例(8.7%)、11例(23%);评分≥6分的患者12例2、7d进展为脑梗死的例数分别为3例(25%)、4例(33.3%),不同ABCD~2评分值的TIA患者,其脑梗死发生率差异有统计学意义(P0.05);ABCD~2评分中的各预测因子Logistic回归分析症状持续时间≥10min及具有局灶体征可以进入回归方程,以此建立的回归方程有效性差异有统计学意义(P=0.000)。结论 ABCD~2评分能够预测TIA患者2、7d内卒中发生率,是临床预测TIA短期进展为脑梗死的一种简便、有效的方法。ABCD~2评分值不同的TIA患者,脑梗死的发生率不同,分值越高,发生率越高;ABCD~2评分中的卒中预测因子,最重要的是局灶体征及症状持续时间萁次为年龄、糖尿病等。

Analysis of ABCD2 score in patients with transient ischemic attack predicted risk of stroke

Objective To investigate the value of the ABCD 2 score in forecasting the risk of stroke after transient ischemic attack(TIA);Methods To sent 98 cases of TIA patients to different groups according to the score of ABCD 2 criteria termed by Johnston,and observe their 2 days, 7days rate of stroke, and compare the difference of each group.Then we assess the predictive value of each risk factor in the score ; Results Of the 40 TIA patients whose score was less than 4,0 had a stroke within 2 days(0%),4 within 7 days(5%).Of the 46 patients with a score of 4 or 5,4 had a stroke within 2 days(8.7%),11 within 7 days(23%).Of the 12 patients at high risk with a score of greater than 5,3 had a stoke within 2 days(25%),4 within 7 days(33.3%) . The incidence of cerebral infarction of TIA patients with a different score had statistically significant differenences (P<0.05).We validate predictive factors in ABCD 2 score relative to stroke in the logistic regression analysis .The results showed that clinical features (motor weakness and speech disturbance )and duration of symptoms ≥10min are highly related with stroke after TIA .They were selected into the regression equation (P=0.000).Conclusion Incidence of cerebral infarction within 2,7 days after presence of TIA was related to the ABCD 2 score.The higher the score,the higher the incidence.The ABCD 2 score is effective and simple for prediction of the short term stroke risk after TIA .We found that the clinical features and duration of symptoms of ABCD 2 score are of greater prognostic value , which may help clinicians identify patients more likely to have had a true TIA.