ABCD2-Ⅰ与ABCD3-Ⅰ评分法预测短暂性脑缺血发作后近期发生脑卒中风险的临床价值比较
发布时间：2018-12-12 07:03
【摘要】：背景短暂性脑缺血发作（transient ischemic attack，TIA）是反复发作的、局灶性脑血管或视网膜动脉缺血导致突发短暂性、可逆性神经功能缺陷。TIA是一种临床急症，其近期发生脑卒中的风险很高，尤其发生在TIA后48小时内。有研究表明，TIA后7d内脑卒中发生率高达35%，且患者90d内TIA复发、心肌梗死和死亡事件总的风险亦较高。因此，对TIA患者进行评估和有效干预对防止脑卒中发生有着重要的意义。 目的探讨并比较采用ABCD2-I与ABCD3-I评分系统预测短暂性脑缺血发作（TIA）患者近期发生脑卒中风险的临床价值。 方法收集154例TIA住院患者的临床和影像学资料。运用ABCD2、ABCD3、ABCD2-I、ABCD3-I评分法进行评分，采用曲线下面积（AUC）值评估并比较ABCD2-I与ABCD3-I评分系统预测TIA后脑卒中风险的价值。 结果154例TIA患者于7d内进展为脑卒中12例（7.8%），90d内19例（12.3%）。将ABCD3-I评分分为低危组（0-3分）、中危组（4-7分）、高危组（8-13分）。分别与低危组、中危组比较，高危组TIA后7和90d脑卒中发生率均明显增高，差异有显著统计学意义（P均0.01）。预测TIA后7d内脑卒中风险时，ABCD2、ABCD2-I、ABCD3、ABCD3-I评分AUC分别为0.733、0.898、0.830和0.935；预测TIA后90d内卒中风险时，分别为0.699、0.857、0.778和0.906。 结论 ABCD3-I评分法预测TIA后脑卒中发生率时，其准确性优于ABCD2-I评分法，，具有更高的临床应用价值。
[Abstract]:Background transient ischemic attack (transient ischemic attack,TIA) is a recurrent attack. Focal cerebral vascular or retinal artery ischemia leads to sudden transient and reversible neurological dysfunction. TIA is a clinical emergency. The risk of recent stroke is high, especially within 48 hours of TIA. Studies have shown that the incidence of stroke is as high as 35% within 7 days after TIA, and the total risk of myocardial infarction and death events is also higher in patients with recurrent TIA within 90 days. Therefore, the evaluation and effective intervention of TIA patients have important significance in preventing stroke. Objective to explore and compare the clinical value of ABCD2-I and ABCD3-I scoring system in predicting the risk of stroke in patients with transient ischemic attack (TIA). Methods the clinical and imaging data of 154 inpatients with TIA were collected. The ABCD2,ABCD3,ABCD2-I,ABCD3-I scoring method was used to evaluate the area under curve (AUC) value and to compare the value of ABCD2-I and ABCD3-I scoring system in predicting the risk of stroke after TIA. Results 12 (7.8%) of the 154 patients with TIA developed stroke within 7 days and 19 (12.3%) within 90 days. ABCD3-I score was divided into low risk group (0-3 points), middle risk group (4-7 points) and high risk group (8-13 points). Compared with low risk group and middle risk group, the incidence of cerebral apoplexy in high risk group was significantly higher than that in low risk group and middle risk group at 7 and 90 days after TIA (P 0.01). In predicting stroke risk within 7 days after TIA, the AUC score of ABCD2,ABCD2-I,ABCD3,ABCD3-I was 0.733-0.8980.0.830 and 0.935 respectively, and that of stroke within 90 days after TIA was 0.6990.8570.778 and 0.906, respectively. Conclusion the accuracy of ABCD3-I scoring method in predicting the incidence of stroke after TIA is better than that of ABCD2-I scoring method, and it has higher clinical application value.
【学位授予单位】：苏州大学
【学位级别】：硕士
【学位授予年份】：2014
【分类号】：R743.3
本文编号：2374149
[Abstract]:Background transient ischemic attack (transient ischemic attack,TIA) is a recurrent attack. Focal cerebral vascular or retinal artery ischemia leads to sudden transient and reversible neurological dysfunction. TIA is a clinical emergency. The risk of recent stroke is high, especially within 48 hours of TIA. Studies have shown that the incidence of stroke is as high as 35% within 7 days after TIA, and the total risk of myocardial infarction and death events is also higher in patients with recurrent TIA within 90 days. Therefore, the evaluation and effective intervention of TIA patients have important significance in preventing stroke. Objective to explore and compare the clinical value of ABCD2-I and ABCD3-I scoring system in predicting the risk of stroke in patients with transient ischemic attack (TIA). Methods the clinical and imaging data of 154 inpatients with TIA were collected. The ABCD2,ABCD3,ABCD2-I,ABCD3-I scoring method was used to evaluate the area under curve (AUC) value and to compare the value of ABCD2-I and ABCD3-I scoring system in predicting the risk of stroke after TIA. Results 12 (7.8%) of the 154 patients with TIA developed stroke within 7 days and 19 (12.3%) within 90 days. ABCD3-I score was divided into low risk group (0-3 points), middle risk group (4-7 points) and high risk group (8-13 points). Compared with low risk group and middle risk group, the incidence of cerebral apoplexy in high risk group was significantly higher than that in low risk group and middle risk group at 7 and 90 days after TIA (P 0.01). In predicting stroke risk within 7 days after TIA, the AUC score of ABCD2,ABCD2-I,ABCD3,ABCD3-I was 0.733-0.8980.0.830 and 0.935 respectively, and that of stroke within 90 days after TIA was 0.6990.8570.778 and 0.906, respectively. Conclusion the accuracy of ABCD3-I scoring method in predicting the incidence of stroke after TIA is better than that of ABCD2-I scoring method, and it has higher clinical application value.
【学位授予单位】：苏州大学
【学位级别】：硕士
【学位授予年份】：2014
【分类号】：R743.3
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相关期刊论文 前2条
1 朱英标;卢丽萍;;ABCD2评分结合头颈CTA对短暂性脑缺血发作后近期发生脑梗死的评估价值[J];中国临床神经科学;2011年06期
2 张晓丹;秦伟;胡文立;;ABCD~3-Ⅰ评分预测短暂性脑缺血发作后早期卒中风险[J];中国卒中杂志;2012年01期
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