应用ABCD3-I评分对短暂性脑缺血发作预后的预测

【摘要】目的探讨ABCD3-I评分在判断短暂性脑缺血发作（，兀A）预后中的价值。方法根据ABCD2、ABCD3、ABCD3-I评分标准，对106例TIA患者进行评定，观察7，90d内脑梗死的发生情况。按照脑梗死风险程度分级，ABCD3．I评分0—3分为低危组（36例），4—7分为中危组（36例），8～13分为高危组（34例）。结果高危组7，90d内脑梗死发生率明显高于低危组和中危组[7d内：23．5％（8／34）比2．8％（1／36）和5．6％（2／36），90d内：38．2％（13／34）比2．8％（1／36）和11．1％（4／36）]，差异有统计学意义（P〈0．01）。ABCD3．I评分中症状持续时间≥10min、伴有糖尿病、双重TIA发作、同侧颈动脉狭窄≥50％、弥散加权成像出现高信号是TIA患者7，90d内发生脑梗死的危险因素（P〈0．05）。ABCD3-I评分预测7，90d内TIA患者脑梗死风险的受试者工作特征曲线下面积均大于ABCD2和ABCD3评分（0．914比0．614和0．877，0．869比0．633和0．773）。结论ABCD3．I评分可更好地预测TIA患者早期脑梗死风险，帮助临床鉴别不同危险级别患者，以便采取最佳的措施分层治疗。

Value of ABCD3- I score in predicting prognosis of transient ischemic attack

Objective To explore the value ofABCD3- I score in predicting prognosis of transient ischemic attack （TIA）. Methods A total of 106 TIA patients were evaluated according to ABCD2, ABCD3 and ABCD3- I criteria. The occurrence of cerebral infarction within 7 d and 90 d was observed. The patients with ABCI）3- l 0 -3 scores were as low risk group （36 cases）, the patients with ABCD3- I 4 -7 scores were as moderate risk group （36 cases）, the patients with ABCD3- I 8 - 13 scores were as high risk group （34 cases）. Results The occurrence of cerebral infarction within 7 d and 90 d in high risk group was lower than that in low risk group and moderate risk group [within 7 d：23.5%（8/34） vs. 2.8%（1/36） and 5.6% （2/36）,within 90 d：38.2%（13/34） vs. 2.8%（1/36） and 11.1%（4/36）],and there was significant difference （P 〈0.01）. Symptom duration time t〉10 rain in ABCD3-I score, concomitant diabetes, double TIA, ipsilateral carotid artery stenosis≥ 50%, high sign in diffusion weighted imaging were the risk factors for the occurrence of cerebral infarction within 7 d and 90 d in TIA patients（P 〈 0.05）. The area under the receiver- operating characteristic curve for predicting the occurrence of cerebral infarction within 7 d and 90 d in TIA patients by ABCD3- I score was higher than that by ABCD2 and ABCD3 score （0.914 vs. 0.614 and 0.877,0.869 vs. 0.633 and 0.773）. Conclusion The ABCD3- I score is a simple and effective way to judge the short-term prognosis of TIA and can help to identify the different risk levels, so it is helpful in stratification treatment.