血清sTREM1联合ABCD-3I评分对短暂性脑缺血发作患者近期缺血性脑卒中的预测价值分析

目的 探讨血清可溶性髓系细胞触发受体1（sTREM1）联合ABCD-3I评分对短暂性脑缺血发作（TIA）患者近期缺血性脑卒中（AIS）的预测价值。方法 288例TIA患者根据ABCD-3I评分将其分为低危组（102例）、中危组（131例）、高危组（55例），另根据患者90 d后是否发生AIS分为AIS组（41例）和非AIS组（247例）。收集患者的年龄、性别、基础疾病等一般资料，采用酶联免疫吸附试验检测血清sTREM1水平。结果 高危组的年龄、糖尿病比例、高血压比例、低密度脂蛋白胆固醇（LDL-C）水平、sTREM1水平和AIS比例均高于中危组和低危组（P<0.05），中危组的sTREM1水平高于低危组（P<0.05）。AIS组年龄、高血压比例、LDL-C水平、ABCD-3I评分、sTREM1水平均高于非AIS组（P<0.05）。多因素Logistic回归模型分析显示，ABCD-3I评分和sTREM1水平较高均是TIA患者近期发生AIS的危险因素（P<0.05）。ABCD-3I评分和sTREM1预测TIA患者发生AIS的曲线下面积分别为0.795（95%CI：0.723~0.867）和0.755（95%CI：0.672~0.839），两者联合后曲线下面积提升至0.881（95%CI：0.830~0.932）。结论 血清sTREM1联合ABCD-3I评分对TIA患者近期AIS的预测价值较高，具有一定的临床应用价值。

Predictive value of serum sTREM1 combined with ABCD-3I score for short-term ischemic stroke in patients with transient ischemic attack

Objective To investigate the predictive value of serum soluble triggering receptors expressed on myeloid cells 1 (sTREM1) combined with ABCD-3I score in the prediction of recent acute ischemic stroke (AIS) in patients with transient ischaemic attack (TIA). Methods A total of 288 TIA patients were selected, and they were divided into the low-risk group (102 cases), the intermediate-risk group (131 cases) and the high-risk group (55 cases) according to their ABCD-3I scores. In addition, the patients were sub-divided into the AIS group (41 cases) and the non-AIS group (247 cases) according to whether AIS occurred after 90 days. The clinical data such as age, sex and basic diseases were collected, and the serum sTREM1 level was detected by enzyme-linked immunosorbent assay. Results The age, proportion of diabetes, proportion of hypertension, low-density lipoprotein cholesterol (LDL-C) level, sTREM1 level and AIS ratio were significantly higher in the high-risk group than those in the intermediate-risk group and the low-risk group (P<0.05). The sTREM1 level was significantly higher in the intermediate-risk group than that in the low-risk group (P<0.05). The age, proportion of hypertension, LDL-C level, ABCD-3I score and sTREM1 level were significantly higher in the AIS group than those in the non-AIS group (P<0.05). Multivariate Logistic regression model analysis showed that both higher ABCD-3I score and higher sTREM1 level were risk factors for recent AIS in TIA patients (P<0.05). The area under the curve of ABCD-3I score and sTREM1 level in predicting AIS in TIA patients were 0.795 (95%CI: 0.723-0.867) and 0.755 (95%CI: 0.672-0.839) respectively, and the area under the curve increased to 0.881 (95%CI: 0.830-0.932) after the combination of ABCD-3I score and sTREM1 level. Conclusion Serum sTREM1 combined with ABCD-3I score has a high predictive value for recent AIS in TIA patients, and which has certain clinical application value.