摘要
目的探讨ABCD^2评分与责任血管狭窄对短暂性脑缺血发作（TIA）后脑梗死发生的预测价值。方法将焦作市人民医院神经内科自2008年至2011年收治的93例TIA患者根据ABCD^2评分分为低危组（20例）、中危组（48例）、高危组（25例），并行DSA检查，根据责任血管狭窄程度分为正常或轻度狭窄（狭窄率〈50％）、中度狭窄（狭窄率50％～69％）、重度狭窄（狭窄率70％～100％）。根据Logistic8回归系数分别对ABCD^2评分及责任血管狭窄程度进行危险因素赋分，通过线性函数转换建立危险评分系统。结果发病7d内低危组脑梗死发生率为5．O％，中危组为10．4％，高危组为36．0％；中、低危组的脑梗死率发生率均明显低于高危组，差异有统计学意义（／9〈0．05）。65例（69．9％1患者有不同程度的责任血管狭窄或闭塞，其中正常或轻度狭窄54例、中度狭窄22例及重度狭窄17例；中度狭窄组及重度狭窄组脑梗死发生率（27．3％、47．1％）均明显高于正常或轻度狭窄组（1．9％），差异有统计学意义（P〈0．05）。基于入院危险因素建立的预测模型性能良好（拟合优度检验P〉0．05，C统计值为0．887）。利用危险评分系统成功地将TIA患者分为低危、中危和高危脑梗死组。模型建立数据中患者进展性脑梗死发生率分别为1．9％、25．0％和47．1％。结论ABCD^2评分及责任血管狭窄程度对TIA患者进展为脑梗死的预测有重要意义。根据ABCD^2评分及责任血管狭窄程度建立的预测模型可以早期、方便、准确地预测TIA后脑梗死的发生，开发的预测工具可辅助临床决策的制定。
Objective To investigate the relationships between cerebral infraction risk and both ABCD2 scale scores and stenosis degree of criminal artery in patients with transient ischemic attack （TIA）. Methods Ninety-three patients with TIA were divided into low risk group, （1-3 scores, n=20）, moderate risk group （4-5 scores, n=48） and high risk group （6-7 scores, n=25） according to the ABCD2 scale scores; and according to the stenosis degree of the criminal artery determined by the cerebral digital subtraction angiography （DSA）, these patients were divided into 3 groups： mild stenosis group （〈50% stenosis, n=54）, moderate stenosis group （50-69% stenosis, n=22） and serve stenosis group （70-100% stenosis, n=17）. Risk factor scoring was performed on ABCD2 scale scores and stenosis degrees of criminal artery according to logistic [3 regression coefficient, and risk factor scoring system was established through linear function transformation. Results According to ABCD2 scale scores, 15 patients （16.1%） were progressed to cerebral infarction in 7 d al^er onset： the incidence of cerebral infarction in low risk group （5.0%） and medium risk group （10.4%） were significantly lower than that in high risk group （36.0%, P〈0.05）. DSA was showed that 65 patients （69.9%） had criminal artery stenosis or occlusion of different degrees. The incidence of cerebral infarction in moderate stenosis group （27.3%） and severe stenosis group （47.1%） was significantly higher than that in mild stenosis group （1.9%, P〈0.05）. The performance of prognostic models developed from admission related risk factors was good, with P〉0.05 for goodness-of-fit test and 0.887 for C statistical value. Patients were divided into low risk cerebral infarction group, moderate risk cerebral infarction group and high risk cerebral infarction group with risk factor scoring system, and their prevalences of progressive hemorrhagic injury were 1.9%, 25.0% and 47.1%, respectively, in the development cohort. Conclusion ABCD2 scale scores and stenosis degrees of criminal artery are significant for evaluating the cerebral infraction risk of patients with transient ischemic attack. The prognostic models established according to the ABCD2 scale scores and stenosis degrees of criminal artery can conveniently and accurately predict the occurrence of intracranial progressive hemorrhagic injury after traumatic brain injury in the early stage, and the developed prediction tool may help in the dicision making in clinics.
出处
《中华神经医学杂志》
CAS
CSCD
北大核心
2013年第3期289-292,共4页
Chinese Journal of Neuromedicine
