ABCD2评分结合管腔狭窄程度对TIA发展为脑梗死的预测价值

摘要

目的 探讨ABCD2评分结合颈内动脉粥样硬化(ICAS)所致管腔狭窄程度对短暂性脑缺血发作(TIA)后7d内发展为脑梗死的预测价值. 方法 选取北京水利医院神经内科自2008年9月至2011年3月收治的171例TIA患者作为研究对象,应用ABCD2评分法进行评分,彩色多普勒超声检查ICAS所致管腔狭窄程度,筛选出TIA发生后7d内发生脑梗死的患者并分析ABCD2评分、管腔狭窄程度对脑梗死发生率的影响. 结果 TIA后7d内发生脑梗死者39例(22.8％)；ABCD2评分、颈内动脉狭窄程度不同患者脑梗死发生率不同,差异有统计学意义(P＜0.05).中危组、高危组患者TIA后7d脑梗死发生率高于低危组,中度狭窄组和重度狭窄或闭塞组脑梗死发生率高于与正常或轻度狭窄组,差异均有统计学意义(P＜0.05). 结论 ABCD2评分、ICAS所致管腔狭窄程度可以影响TIA后7d内脑梗死的发生,两者结合对于TIA后7d内发展为脑梗死更有预测价值.%Objective To explore the predictive value of combined ABCD2 scores and tracheal constriction resulted from internal carotid atherosclerosis (ICAS) in cerebral infarction within 7 d of onset of a transient ischemic attack (TIA). Methods The clinical data of 171 patients with TIA,admitted to our hospital from September 2008 to March 2011, were retrospectively analyzed. All patients were evaluated with ABCD2 scale and degrees of tracheal constriction resulted from ICAS were examined by Color Doppler ultrasound.And 7-d follow-up of patients was performed to select those patients appearing cerebral infarction; and then, the relationships between risk of post-TIA cerebral infarction and both ABCD2 scores and degrees of tracheal constriction were analyzed using chi-square test. Results Among 171 TIA patients,39 (22.8％) suffered cerebral infarction within 7 d of onset of TIA.Significant difference of risk of post-TIA cerebral infarction was noted in patients with different ABCD2 scores and degree of tracheal constriction (P＜0.05): the higher the ABCD2 scores/ the degrees of tracheal constriction, the higher incidence of cerebral infarction in TIA patients. Conclusion A rather high accuracy may be achieved with ABCD2 scale in the prediction of short-term risk of cerebral infarction after onset of TIA,and a higher accuracy may be expected by combination of ABCD2 scale with carotid atherosclerosis findings.