ABCD2评分结合头颈部CT血管成像对短暂性脑缺血后发生脑梗死的预测价值

摘要

目的：分析ABCD2评分结合头颈部CT血管成像（CTA）对于短暂性脑缺血发作（TIA）后发生脑梗死的预测价值，为临床诊断提供参考。方法：选择2013年1月-2014年10月来本院神经内科因TIA发作后发生脑梗死的158例患者为观察对象。所有患者住院期间均行CTA检查及ABCD2评分，记录颅内动脉狭窄的程度，进行比较分析。结果：患者ABCD2评分与TIA后2、7及30 d内脑梗死发生率之间分别呈正相关关系。中危组与低危组在TIA后2及30 d脑梗死发生率比较，差异具有统计学意义（P<0.05）；高危组与低危组在TIA后2、7及30 d脑梗死发生率比较，差异具有统计学意义（P<0.05）；高危组与中危组在TIA后2及30 d脑梗死发生率比较，差异具有统计学意义（P<0.05）。患者颈内动脉狭窄程度与TIA后2、7及30 d内脑梗死发生率之间分别呈正相关关系。中度颈内动脉狭窄与正常或轻度狭窄患者在TIA后7及30 d脑梗死发生率比较，差异具有统计学意义（P<0.05）；重度颈内动脉狭窄或闭塞与正常或轻度狭窄患者在TIA后2、7及30 d脑梗死发生率比较，差异具有统计学意义（P<0.05）；重度颈内动脉狭窄或闭塞与中度狭窄患者在TIA后7及30 d脑梗死发生率比较，差异具有统计学意义（P<0.05）。不同狭窄程度患者中（正常或轻度狭窄、中度狭窄、重度狭窄或闭塞）不同ABCD2评分（低危组、中危组与高危组）患者TIA后2、7及30 d脑梗死的发生率比较，差异均有统计学意义（P<0.05）。结论：ABCD2评分结合CTA对预测TIA患者2、7及30 d内脑梗死发生概率具有重要意义，能够显著提高预测的准确性，具有重要的临床实用和推广价值。%Objective: To analyze ABCD2 score combined with head and neck CT angiography (CTA) in prediction of the occurrence of cerebral infarction after TIA, in order to provide reference for clinical diagnosis. Method: From January 2010 to May 2014 in our hospital, 158 patients with occurrence of cerebral infarction TIA after onset were selected as objects. All the patients were examined by CTA and ABCD2 scores, recorded intracranial artery stenosis degree.Result: In patients with ABCD2 score and TIA after 2, 7, and 30 days cerebral infarction were positively correlated with the rate of risk group and low risk group the ABCD2 score in TIA, 2 and 30 days after cerebral infarction between with significant difference (P<0.05); the ABCD2 score of high-risk group and low-risk group in TIA, 2, 7 and 30 days of cerebral infarction occurrence with significant difference (P<0.05); the ABCD2 score and the high risk group in the risk group in TIA 2 and 30 days after cerebral infarction with significant difference (P<0.05). 2, 7, and 30 days cerebral infarction were positively correlated with the rate of carotid artery stenosis in patients with TIA after degree. The degree of stenosis of internal carotid artery and moderate stenosis and normal or mild stenosis after TIA 7 and 30 days between the rate of cerebral infarction with significant difference (P<0.05); the degree of stenosis of internal carotid artery stenosis or occlusion with normal or mild stenosis after TIA 2, 7, and 30 days of cerebral infarction incidence with significant difference (P<0.05); the degree of stenosis of internal carotid arterystenosis or occlusion and moderate stenosis after TIA 7 and 30 days between the rate of cerebral infarction with significant difference (P<0.05). The different degree of stenosis group (normal or mild stenosis group, moderatestenosis group, moderate to severe stenosis or occlusion group) in different ABCD2 score (low risk, medium risk, and high risk) in patients with TIA after 2, 7, and 30 days, the incidence of cerebral infarction group had statistical significance (P<0.05).Conclusion: ABCD2 score combined with head and neck CT angiography in predicting TIA has an important significance in patients with 2, 7, and 30 days in cerebral infarction occurrence probability, can significantly improve the prediction accuracy, and it has important clinical utility and popularization value.