前循环短暂性脑缺血发作患者脑血管狭窄特点与ABCD2评分

目的探讨动脉粥样硬化性前循环短暂性脑缺血发作(TIA)患者中,动脉狭窄位置和狭窄程度与ABCD2评分的相关性。方法选择南京卒中注册系统中,接受数字减影血管造影(DSA)检查的前循环动脉粥样硬化性TIA患者1 51例进行ABCD2评分,根据ABCD2评分分值分为3组:低危组60例,中危组64例,高危组27例。分析患者脑血管形态学特点与各组的关系。结果 DSA显示,151例患者中,25例为正常血管,126例血管狭窄的患者检出216处狭窄或闭塞性病变。3组患者血管狭窄位置的分布差异无统计学意义(P>0.05);在症状相关侧大血管中,低危组患者正常血管的比例明显高于高危组,轻度狭窄的比例明显高于中危组和高危组,重度狭窄及闭塞的比例明显低于中危组和高危组,差异有统计学意义(P<0.05);在非症状相关侧大血管中,低危组患者正常血管的比例明显高于中危组和高危组,高危组患者中度狭窄的比例明显高于低危组和中危组,差异有统计学意义(P<0.05)。有症状和无症状侧血管的管腔狭窄程度随ABCD2评分的增高而表现出升高趋势(P<0.01)。结论前循环TIA患者的ABCD2评分能够反映患者前循环血管的狭窄程度。ABCD2评分高的前循环TIA患者应重视血管形态学检查。

Characteristics of cerebrovascular stenosis and ABCD2 scores in patients with transient ischemic attack of anterior circulation

Objective To investigate the correlation between atherosclerotic cerebral artery stenosis and ABCD2 scores in patients with transient ischemic attack(TIA) in anterior circulation.Methods A total of 151 patients with atherosclerotic TIA in anterior circulation were selected from the Nanking Stroke Registry Program.All patients underwent digital subtraction angiography (DSA) and were evaluated with ABCD2 system.The patients were divided into 3 groups according to ABCD2 scores:60 patients with low risk,64 patients with moderate risk and 27 patients with high risk.The relationship between the characteristics of angiograms and the score levels was analyzed.Results DSA results showed 216 sites of stenosis in 126 patients.The distribution of these stenoses was not significantly different among the three groups,but the severity was statistically different.Patients with a higher score of ABCD2 system were likely to present higher degree of stenosis in anterior cerebral arteries not only in the symptom-relevant side,but also in the opposite side.Conclusion ABCD2 scores of carotid territory TIA can predict the severity of the stenosis in anterior circulation.The physicians should pay more attention to the patients with high ABCD2 score in clinical practice.