应用ABCD^2评分法和纤维蛋白原预测TIA后短期脑卒中风险

目的探讨ABCD^2＋纤维蛋白原评分法对短暂性脑缺血发作后7d内发生脑梗死的预测价值。方法用ABCD^2评分法和ABCD^2＋纤维蛋白原评分法分别测定135例TIA患者的评分，并观察TIA后7d内脑梗死的发生率。结果ABCD^2＋纤维蛋白原评分法和ABCIY评分法的曲线下面积（95％CI）分别为0．755（0．668-0．842）和0．711（0．618-0．804）。135例TIA患者中42分者13例，脑梗死的发生率为零；评分为3分者12例，脑梗死的发生率为8％；评分为4分者30例，脑梗死的发生率为17％；评分为5分者40例，脑梗死的发生率为25％；评分为6分者28例，脑梗死的发生率54％；评分≥7分者12例，脑梗死的发生率为58％。低危（0～3分）、中危（4-5分）和高危（6～8分）组TIA后7d内发生脑梗死的比例分别为4％、21％和55％（P〈0．05）。结论ABCD^2＋纤维蛋白原评分法的预测价值高于ABCD^2评分法。ABCD^2＋纤维蛋白原评分标准是临床上预测TIA短期进展为脑梗死的一种比较有效的方法。

Early stroke risk prediction after transient ischemic attack with ABCD2+Fib score

Objective To explore the ability of ABCD^2＋ Fib score in predicting cerebral infarction of transient ischemic attack patients at 7th day. Methods 135 TIA patients were evaluated according to ABCD^2 criteria and ABCD^2 ＋ Fib criteria. The occurrences of cerebral infarction were observed in 7 days. Results The AUCs （95%CI） of ABCD^2＋ Fib and ABCD2 were 0. 755（0. 668-0. 842） and 0. 711 （0. 618-0. 81）4）. respectively 13 TIA patients scored 2 or less, and the occurrence of cerebral infarction was 0. 12 patients scored 3, and the occurrence was 8%. 30 patients scored 4, and the occurrence is 17%. 40 patients scored 5, and the occurrence was 25%. 28 patients scored 6, and the occurrence was 54%. 12 TIA patients scored 7 or more, and the occurrence was 58%. The 7-day risk of stroke was 4% in patients with an ABCD^2 score of low risk（0-3） ,21% with a score of moderate risk （4-5） ,and 55% with a score of high risk （648） （P〈0. 05）. Conclusions The predictive accuracy of the ABCD^2 ＋ Fib is significantly higher than that of ABCD^2. ABCD^2＋ Fib criteria is effective to predict the occurrence of cerebral infarction in short-term of TIA.