短暂性脑缺血发作患者ABCD^2评分与脑血管狭窄相关性初步研究

Pilot Study of the Relationship between Cerebrovascular Stenosis and ABCD^2 score in Transient Ischemic Attack Patients

目的评价短暂性脑缺血发作（transient ischemic attack,TIA）患者ABCD^2评分和脑血管狭窄之间的关系。方法回顾性研究了88例TIA患者ABCD2评分和颅脑磁共振血管成像（magnetic resonance angiography,MRA）影像资料,根据ABCD^2评分分为评分≥4分组和评分〈4分组,根据MRA评估分为血管狭窄≥50%组和狭窄〈50%组,评价ABCD^2评分与脑血管狭窄之间的相关性。结果血管狭窄≥50%组与狭窄〈50%组比较,ABCD^2评分≥4分的比率增高[74.4%vs44.9%,比值比（oddsratio,OR）3.559,95%可信区间（credibility interval,CI）1.428～8.868,P=0.005];既往有卒中病史的患者比率增高（33.3%vs10.2%,OR=4.400,95%CI1.408～4.869,P=0.01）;脑血管狭窄≥50%组与狭窄〈50%组比较,前者TIA后2d内卒中发生率明显增高（10.3%vs0%,OR=0.417,95%CI0.324～0.537,P=0.04）。结论ABCD2评分≥4分MRA示颅内血管狭窄率高,既往有卒中病史的TIA患者颅内血管狭窄率增高,颅内血管狭窄≥50%TIA后2d内发生卒中的风险增高。

Objective To evaluate the relationship between ABCD^2 score and cerebrovacular stenosis of patients with transient ischemic attack（TIA）. Methods We retrospectively reviewed the medical records of 88 patients with TIA; all of them were examined with the magnetic resonance angiography（MRA）. All patients were divided into two groups according to cerebrovascular vascular stenosis ≥50% or not, and divided into two groups according to ABCD^2 score ≥4 point or not. The relationship between ABCD^2 score and cerebrovaculare vascular stenosis was analyzed. Results Group stenosis ≥50% were more likely to have ABCD^2 score ≥4 compared with group stenosis 〈50%（74.4% vs 44.9%, OR=3.559, 95%CI 1.428-8.868, P=0.005）. Group stenosis ≥50% were more likely to have stroke history than those stenosis 〈50%（33.3% vs 10.2%, OR=4.400, 95%CI 1.408-4.869, P=-0.01）. The stroke within 2 days after TIA is higher in group cerebrovascular stenosis ≥50% than that in group stenosis 〈50%（10.3% vs 0%, OR=0.417, 95%CI 0.324-0.537, P=0.04）. Conclusion The patients with ABCD^2 score≥4 show higher rate of cerebrovascular stenosis. Patients with previous stroke more likely to undergo cerebrovascular vascular stenosis. The stroke within 2 days after TIA is higher in patients with cerebrovascualr stenosis ≥50%.