DSA与TCD分别联合ABCD2评分对TIA患者近期发生脑梗死的评估价值比较

目的比较ABCD2评分联合经颅多普勒（TCD）或脑血管造影检查（DSA）对短暂性脑缺血发作（TIA）后7d发生脑梗死的评估价值。方法以2008年1月-2013年1月住院治疗的246例TIA患者为研究对象，收集临床、TCD及DSA相关临床资料。ABCD2评分≤3分为低危组（n=150），4～5分为中危组（n=72），6～7分为高危组（n=24）。血管狭窄程度〈50％为轻度狭窄，≥50％为中重度狭窄。比较TCD和DSA分别对ABCD2评分低危组以及高危组TIA患者7d发生脑梗死的评估价值。结果104例（42．3％）患者在TIA后7d内发生脑梗死。ABcD2评分越高，脑梗死的发生率越高（P均〈0．01）。ANZIY评分中、高危患者中DSA显示血管中、重度狭窄患者（≥50％）7d发生脑梗死的概率显著高于TCD患者（P〈0．01），而在ABCD评分低危患者中无显著差异（P〉005）。结论对于ABCD2评分中、高危患者，DSA检查能准确预测7d发生脑梗死的概率。

A comparative study in diagnosis of cerebral infarction after transient ischemic attack in the near future between ABCD2 combined with digital subtract angiography or transcranial Doppler

Objective tract angiography （DSA） or To compare the clinical value transcranial Doppler （TCD） in of ABCD2 combined with digital sub the diagnosis of patients with cerebral infarction after transient ischemic attack （TIA） in the near future. Methods Clinical materials, DSA and TCD findings of 246 hospitalized TIA patients from January 2008 to January 2013 were collected and analyzed. According to ABCD2 score, the patients were divided into three groups： low risk group （score 13, n = 150）, moderate risk group （score 45, n = 72） and high risk group （score 67, n = 24）. According to degree of cerebral vascular stenosis, the patients were di videdinto low group （〈50%） and moderate or high group （50%）.Results Among 246 pa tients, 104 patients（42.3 % ） died of cerebral infarction within 7 days after onset of T1A. Patients in high risk group were most likely to experience cerebral infarction, then in moderate and low risk groups （all P〈0. 01）. The incidence of cerebral infarction within 7 days in the patients with ABCD2-4 and cerebral vascular stenosis 50 % by DSA was higher than those in patients detected by TCD （P〈O. 01）, but there was no significant difference in the patients with ABCD2-3 （P 〉 0.05）. Conclusion DSA may be an optimal choice for the prediction of cerebral infarction of TIA