应用ABCD3-Ⅰ评分法预测短暂性脑缺血发作患者早期卒中风险

摘要

Objective To assess the ability of ABCD3-Ⅰ score in evaluating the early risk of cerebral infarction after transient ischemic attack ( TIA ).Methods A total of 107 TIA patients were evaluated according to ABCD2,ABCD3 and ABCD3-Ⅰ criteria.The occurrences of cerebral infarction within 2 days and 7 days were observed.Results The AUCRoc of ABCD2,ABCD3 and ABCD3-Ⅰ were 0.61,0.66 and 0.71 in predicting the risk of cerebral infarction within 2 days,and were 0.62,0.68 and 0.74 in predicting within 7 days,respectively.Among 107 patients with TIA,13 evolved into cerebral infarction within 2 days,accounting for 12.1％,and 24 within 7 days,accounting for 22.4％.According to ABCD3-Ⅰ criteria,17 patients were of low risk scored 0-3 ; 54 patients were of medium risk scored 4-7 ; and 36 patients were of high risk scored 8-13.The different incidence of cerebral infarction after TIA was related to ABCD3-Ⅰ score:the higher the score was,the higher incidence was.Except for age factor,every score item of ABCD3-Ⅰ display obvious influence to the occurrence of cerebral infarction within 2 days and 7 days after TIA (P ＜ 0.05 ).Conclusion ABCD3-Ⅰ criteria could more effectively predict the occurrence of early risk of cerebral infarction after TIA,which could be used in regular clinical practice for assistance in TIA risk stratification and treatment.%目的 探讨应用ABCD3-Ⅰ评分评估短暂性脑缺血发作(TIA)患者早期卒中风险.方法 分别采用ABCD2、ABCD3与ABCD3-Ⅰ评分标准对107例TIA患者进行评分,并观察患者TIA后2d和7d内脑梗死的发生率.结果ABCD2、ABCD3与ABCD3-Ⅰ评分法预测2d内脑梗死风险的ROC曲线下面积(AUCRoc)分别为0.61、0.66和0.71,预测7d内脑梗死风险的AUCRoc分别为0.62、0.68和0.74.107例TIA患者2d内进展为脑梗死者13例(12.1％),7d内进展为脑梗死者24例(22.4％).其中ABCD3-Ⅰ评分0～3分的低危组患者17例,4～7分的中危组患者54例,8～13分的高危组患者36例,评分值越高TIA后短期内脑梗死发生率越高.除年龄因素外,ABCD3-Ⅰ评分法中各个评分项目对TIA后2d和7d内脑梗死发生率均有明显影响(P＜0.05).结论 ABCD3-Ⅰ评分法可更好地预测TIA后早期缺血性卒中风险,可作为常规应用于临床,指导TIA危险分层评价和治疗.