摘要
目的:探讨磁共振灌注加权成像(MR-PWI)联合ABCD2评分预测短暂性脑缺血发作(TIA)后脑梗死的价值。方法:选取短暂性脑缺血患者127例,根据患者是否发生继发性脑梗死分为梗死组(n=49)和TIA组(n=78),根据ABCD2评分分为低危组(n=51)、中危组(n=48)和高危组(n=28),根据MR-PWI检测结果分为阴性组(n=55)和阳性组(n=72)。对患者一般临床资料进行记录,多因素Logistic回归分析其危险因素,受试者工作特征(ROC)曲线分析ABCD2评分联合MR-PWI对TIA后继发性脑梗死的预测价值。结果:高危组TIA患者在7 d和30 d内发生继发性脑梗死的概率最高,其次分别为中危组和低危组(均P>0.05)。MR-PWI阳性组TIA患者7 d内和30 d内进展为脑梗死概率明显高于MR-PWI阴性组(均P<0.05)。与TIA组相比,梗死组评分中高危、MR-PWI阳性、有高血脂症史患者占比和纤维蛋白原水平明显较高(均P<0.05)。纤维蛋白原水平高、ABCD2评分为中高危、MR-PWI阳性是TIA进展为脑梗死的危险因素(均P<0.05)。MR-PWI、ABCD2评分、纤维蛋白原三者联合预测TIA后脑梗死灵敏度和特异度明显高于三者独立检查(均P<0.05)。结论:MR-PWI联合ABCD2评分对患者TIA后脑梗死预测价值较高,值得临床使用。
Objective:We reviewed the value of the cerebral apoplexy Risk Assessment Table(ABCD2)scoring table combined with magnetic resonance imaging weighted imaging(MR-PWI)in the prediction of short-term ischemic cerebral infarction.Methods:A total of 127 patients with transient cerebral ischemia were selected and divided into infarction group(n=49)and TIA group(n=78)according to whether they had secondary cerebral infarction,and were divided into low-risk group(n=51),medium-risk group(n=48)and high-risk group(n=28)according to ABCD2 score.According to the MR-PWI test results,they were divided into negative group(n=55)and positive group(n=72).The general clinical data of the patients were recorded,the risk factors were analyzed by multivariate Logistic regression,and the predictive value of ABCD2 score combined with MR-PWI was analyzed by receiver operating characteristic(ROC)curve.Results:TIA patients in high-risk group had the highest probability of secondary cerebral infarction within 7 and 30 days,followed by medium-risk group and low-risk group(all P>0.05).The probability of TIA patients in MR-PWI positive group progressing to cerebral infarction within 7 days and 30 days was significantly higher than that in MR-PWI negative group(all P<0.05).Compared with TIA group,the proportion of patients with high risk score,MR-PWI positive score,history of hyperlipidemia and fibrinogen level in infarction group were significantly higher(all P<0.05).High fibrinogen level,moderate and high risk ABCD2 score and positive MR-PWI were the risk factors for TIA progression to cerebral infarction(all P<0.05).The sensitivity and specificity of MR-PWI,ABCD2 score and fibrinogen combined to predict cerebral infarction after TIA were significantly higher than that of independent examination(all P<0.05).Conclusion:MR-PWI and ABCD2 scores have high predictive value for cerebral infarction progression in TIA patients and therefore deserve widespread clinical use.
作者
张晨
王晓嘉
ZHANG Chen;WANG Xiaojia(Department of Encephalopathy,East Hospital,Beijing University of Chinese Medicine,Beijing 100075,China)
出处
《陕西医学杂志》
2025年第7期934-938,共5页
Shaanxi Medical Journal
基金
北京市重点研发计划项目(2024FETD10237)。
关键词
磁共振成像
灌注加权成像
ABCD2评分
短暂性脑缺血
脑梗死
预测
Magnetic resonance imaging
Perfusion weighted imaging
ABCD2 score
Transient cerebral ischemia
Cerebral infarction
Forecast
