采用ABCD评分预测短暂性脑缺血发作短期进展为脑梗死的价值

The short-term's advancement prediction from transient ischemic attack to cerebral infarction by Rothwell's ABCD criteria

目的探讨采用ABCD评分预测短暂性脑缺血发作(Transient Ischemic Attack,TIA)短期进展为脑梗死的价值。方法按照Rothwell对TIA的ABCD评分标准,测定103例TIA患者的评分和观察7d内脑梗死的发生率。结果评分≤3分的TIA患者有41例,脑梗死的发生率为零;评分4分的TIA患者有27例,脑梗死的发生率为18%;评分5分的TIA患者有22例,脑梗死的发生率为40%;评分6分的TIA患者13例,脑梗死的发生率为85%。在年龄≥60岁、血压140/90mmHg、偏瘫伴口齿含糊、症状持续时间≥60min的患者中脑梗死的发生率明显增高,而在单纯偏瘫和单纯口齿含糊的患者中脑梗死的发生率无明显增高。结论TIA患者不同的ABCD评分值7d内脑梗死的发生率不同,分值越高,发生率越高;反之,分值越低,发生率越低;Rothwell的ABCD评分标准是临床上预测TIA短期进展为脑梗死的一种比较有效的方法。

Objective To explore the risk factors influenting acute transient ischemic attack（TIA） to evolve into cerebral infarction. Methods 103 TIA patients were evaluated according to Rothwell＇s ABCD criteria. The occurrences of cerebral infarction were observed in 7 days. Results 41 TIA patients scored 3 or less, and the occurrence of cerebral infarction is 0; 27 patients scored 4, and the occurrence is 18%; 22 patients scored 5, and the occurrence is 40%; 13 TIA patients scored 6, and the occurrence is 85%. The occurrence was significantly higher in patients older than 60, with blood pressure over 140/90 mmHg, hemiparesis and anarthria, and symptoms lasting over 60 minutes. The occurrence did not change significantly in patinents only with hemiparesis or anarthria. Conclusions The different incidence of cerebral infarction within 7 days of TIA is related to Rothwell＇s scores. The higher the scores is, and the higher incidence is; the lower, and the lower. Rothwell＇s ABCD criteria is effective to predict the occurrence of cerebral infarction in short-term of TIA.