缺血修饰白蛋白对前循环短暂性脑缺血发作患者继发脑梗死的预测研究

Predictive value of ischemia-modified albumin level in secondary cerebral infarction after transient ischemic attack in anterior circulation

目的 研究缺血修饰白蛋白（IMA）水平对预测前循环短暂性脑缺血发作（TIA）患者继发脑梗死的价值. 方法 回顾性研究105例3h内人院的前循环TIA患者3h内、6h及12 h IMA水平并结合ABCD2评分,分析其与前循环TIA后继发脑梗死的相关性. 结果 3h内IMA为75.28 U/L时,诊断前循环TIA的敏感度为66.7％,特异性为76.2％.105例患者7d内继发脑梗死患者16例（15.2％）,8～30 d内继发脑梗死21例（20.0％）.前循环TIA患者3h内、6h及12h的IMA平均水平为（87.43±19.89） U/L、（63.88±12.51） U/L、（61.21±12.28） U/L,Pearson-Correlation分析显示3h内IMA水平与ABCD2评分呈直线相关（P=0.000,r=0.666）.Kaplan-Meier生存曲线显示3h内IMA异常升高、中～高危ABCD2评分均为前循环TIA发作后继发脑梗死的危险因素（P=0.012、0.041）. 结论 早期IMA水平的检测与ABCD2评分对预测前循环TIA患者继发脑梗死具有相似的临床价值.

Objective To predict a value of ischemia modified albumin （IMA） levels for assessing secondary cerebral infarction in patients with transient ischemic attack （TIA） in anterior circulation.Methods 105 patients with TIA in anterior circulation admitted to the hospital within 3 hours were retrospectively studied.Combined with ABCD2 score,the correlations of IMA levels at 3 h,6 h and 12 h with secondary cerebral infarction after anterior circulation TIA were analyzed.Results IMA level was 75.28 u/L within 3h after TIA,and the sensitivity and specificity of TIA in anterior circulation were 66.7％ and 76.2％ respectively.In the total of 105 patients,16 cases （15.2％） suffered from secondary cerebral infarction within 7d,and 21 cases （20.0％） within 8～30d.The serum IMA levels were （87.43±19.89）U/L,（63.88±12.51）U/L and （61.21±12.28）U/L at 3h,6h and 12h after TIA,respectively.A simple analysis showed that there was a linear correlation between the IMA level and ABCD2 scores （P=0.000,r=0.666）.Kaplan-Meier survival curve analysis showed that the increased IMA level within 3h,and moderate to high ABCD2 score were the risk factors for secondary cerebral infarction after TIA in anterior circulation （P=0.012,0.041）.Conclusions Early detection of IMA has a clinical value similar to ABCD2 score to predict secondary cerebral infarction in patients with TIA in anterior circulation.