ABCD2评分联合血清高敏C反应蛋白检测对短暂性脑缺血发作患者发生脑梗死风险的预测价值

摘要

Objective To investigate the predictive value of ABCD 2 score combined with serum high-sensitivity C-reactive protein ( hs-CRP) detection of transient ischemic attack ( TIA) patients within a month of acute stroke .Methods Retrospective analysis of 121 patients with TIA who admitted to department of neurology from November 2011 to October 2013 , 35 cases of acute stroke were occurred within a month as stroke group , 86 cases did not occur as the control group .Analysis of differences of two groups'patient ABCD2 score and serum hs-CRP levels , and their predictive value in patients occurred within a month of acute stroke.Results ABCD2 score was higher in stroke patients [(6.1 ±1.2) points vs.(4.2 ±1.6) points ],the proportion of high-risk patients was significantly higher (94.3% vs.2.4%),the differences were statistically significant ( P <0.05); stroke group hs-CRP levels (23.71 ±4.56) mg/L,was higher than the control group (11.48 ± 3.88) mg/L ( P <0.05);TIA patients'hs-CRP levels and ABCD2 score was positively correlated ( r =0.56, P <0.05);serum hs-CRP as a predictor of acute stroke within a month in TIA patients with the area under the ROC curve of 0.86 (95%CI 0.79-0.93), as 16.78 mg /L to be the cut off value, the prediction of acute stroke in TIA patients as sensitivity of 80. 7%, specificity of 60.8 %.Conclusion Recent acute stroke ABCD2 score and plasma hs-CRP were significantly higher in patients with TIA , ABCD2 score and hs-CRP detection can be important predictors of stroke in patients with recent TIA .%目的：探讨ABCD2评分联合血清高敏C反应蛋白（ hs-CRP）检测对短暂性脑缺血发作（ TIA）患者1个月内发生急性脑卒中的预测价值。方法回顾性分析神经内科2011年11月-2013年10收治的TIA患者121例，其中1个月内发生急性脑卒中者35例作为卒中组，未发生者86例作为对照组。分析2组患者ABCD2评分及血清hs-CRP水平的差异，及其预测患者1个月内发生急性脑卒中的价值。结果卒中组患者ABCD2评分高于对照组[（6'．1±1．2）分vs．（4．2±1．6）分]，高危患者比例显著高于对照组（94．3％vs．2．4％），差异均有统计学意义（ P ＜0．05）；卒中组hs-CRP水平为（23．71±4．56）mg/L，高于对照组的（11．48±3．88）mg/L（ P ＜0．05）；TIA患者hs-CRP水平与ABCD2评分呈正相关（ r ＝0．56， P ＜0．05）；以患者血清hs-CRP作为预测TIA患者在1个月内发生急性脑卒中的指标，其ROC曲线下面积为0．86（95％CI 0．79～0．93），以16．78 mg/L为cut-off值，其预测TIA发生急性脑卒中的敏感度为80．7％、特异度为60．8％。结论近期发生急性脑卒中的TIA患者ABCD2评分及血浆hs-CRP均显著升高，ABCD2评分及hs-CRP检测可作为预测TIA患者近期发生脑卒中的重要指标。