短暂性脑缺血发作患者ABCD^2评分与颈动脉狭窄对脑梗死危险的评估研究

The evaluation of carotid stenosis and ABCD^2 scores of cerebral infarction risk in patients with transient ischemic attack

目的分析ABCD2评分与颈动脉狭窄对短暂性脑缺血发作(TIA)后30 d脑梗死发生的评估价值。方法以住院的173例TIA患者为研究对象,收集其临床资料和颈动脉超声检查结果,随访TIA后30 d内脑梗死的发生率,并分析"ABCD2"评分、颈动脉狭窄程度与TIA后短期内发生脑梗死的关系。结果颈动脉狭窄≥50%的TIA患者128例,发生脑梗死46例(35.9%);颈动脉狭窄<50%的TIA患者45例,发生脑梗死9例(20%),两组比较差异有统计学意义(P<0.05);ABCD2评分越高,脑梗死的发生率越高(P<0.05),颈动脉狭窄越重,ABCD2评分越高(Gamma=0.433,P<0.05)。结论 ABCD2评分法对TIA后脑梗死发生有预测价值,ABCD2评分结合彩色多普勒超声对颈动脉狭窄度检查能进一步提高TIA脑梗死预测的准确性。

Objective To investigate the correlation between carotid stenosis and ABCD2 scores in patients with transient ischemic attack（TIA）,and to validate carotid stenosis and ABCD2 scores in predicting cerebral infarction of transient ischemic attack（TIA） 30 days after diagnosis.Methods A total of 173 patients with atherosclerotic TIA were selected and all patients underwent carotid artery ultrasonic examination and were evaluated with ABCD2 system.The patients were divided into 3 groups according to ABCD2 scores and the probability of cerebral infarction was investigated after transient ischemic attack.The relationship between the carotid stenosis and the score levels were analyzed.Results 46 cases of 173 patients who had carotid stenosis which was more than 50% occurred cerebral infarction;9 cases of 45 patients who had carotid stenosis which was less than 50% occurred cerebral infarction.The occurrence was significantly higher in the patients who had carotid stenosis which was more than 50%（P0.05）,and patients with a higher score of ABCD2 system were likely to present severely carotid stenosis,the occurrence of cerebral infarction was significantly higher.Conclusion The ABCD2 score is effective to predict short term risk of cerebral infarction in the patients with TIA.Combination with the findings of carotid artery ultrasonic examination can improve the predictive accuracy of cerebral infarction after TIA.