ABCD2评分结合血清尿酸水平评估短暂性脑缺血发作后患者短期脑卒中的风险

发布时间：2018-05-03 01:33

本文选题：短暂性脑缺血发作 + 年龄、血压、临床表现、症状持续时间、糖尿病(ABCD)　；参考：《中国老年学杂志》2017年18期

【摘要】：目的探讨年龄、血压、临床表现、症状持续时间、糖尿病(ABCD2)评分结合血清尿酸水平预测短暂性脑缺血发作(TIA)进展为短期脑卒中风险时的应用价值。方法选取年龄61~88岁,中位年龄75岁的TIA患者,对其进行ABCD2评分,并在发病后第2天空腹抽取静脉血测定尿酸。记录7 d内脑梗死事件的发生率。绘制受试者工作特征(ROC)曲线,观察曲线下面积(AUC),评估ABCD2评分法及结合血清尿酸水平的应用价值。结果 ABCD2评分法及其结合血清尿酸水平两种评分方法 95%的可信区间(CI)分别为:0.661(0.543~0.778),0.754(0.650~0.859)。ABCD2评分结合血清尿酸水平AUC显著大于ABCD2(P0.05)。血清尿酸水平结合ABCD2评分可将TIA患者分为高危(6~8分)、中危(4~5分)、低危(0~3分)3组,7 d内发生脑梗死的概率分别为51.9%、21.2%和4.8%,3组差异显著(P0.05)。结论 ABCD2评分结合血清尿酸水平预测价值优于ABCD2评分法,可以成为临床上预测TIA患者发生短期脑卒中概率的一种有效方法。
[Abstract]:Objective to investigate the value of age, blood pressure, clinical manifestation, symptom duration, diabetes mellitus ABCD2 score and serum uric acid level in predicting the progression of transient ischemic attack (TIA) to short-term stroke risk. Methods the patients with TIA aged from 61 to 88 years old with a median age of 75 years were assessed with ABCD2, and fasting venous blood samples were taken to determine uric acid on the second day after onset. The incidence of cerebral infarction within 7 days was recorded. The operating characteristic curve was drawn and the area under the curve was observed to evaluate the application value of ABCD2 scoring method and serum uric acid level. Results the 95% confidence interval (CI) of ABCD2 scoring method and its combined serum uric acid level were: 1 / 0.661/ 0.543 / 0.778nb 0.754 / 0. 650 / 0. 859U. ABCD2 score combined with serum uric acid level AUC was significantly higher than that of ABCD2 / P0. 05 / 0. 05% respectively. Serum uric acid level combined with ABCD2 score could divide TIA patients into high risk group (6 ~ 8), moderate risk group (4 ~ 5) and low risk group (0 ~ 3 min). The probability of cerebral infarction within 7 days in 3 groups was 51.9% and 4.8% respectively. Conclusion the predictive value of ABCD2 score combined with serum uric acid level is better than that of ABCD2 score. It can be an effective method to predict the probability of short-term stroke in TIA patients.
【作者单位】：无锡市人民医院神经内科;无锡市人民医院检验科;
【分类号】：R743.31

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