ABCD^3-I评分法预测短暂性脑缺血发作患者早期脑卒中风险

Application of ABCD^3-I score in predicting risk of early ischemic stroke after transient ischemic attack

目的探讨ABCD3-I评分法对短暂性脑缺血发作(TIA)患者早期脑卒中风险的预测价值。方法选取颈内动脉系统TIA患者182例,分别采用ABCD2、ABCD3、ABCD3-I评分标准进行评分,其中ABCD3-I危险分层分为低危40例,中危74例,高危68例,并观察TIA后7d内脑梗死的发生率。结果 ABCD2、ABCD3与ABCD3-I评分法预测TIA后7d内脑梗死风险的ROC曲线下面积分别为0.625、0.713、0.831。TIA患者7d内进展为脑梗死27例(14.8%)。ABCD3-I评分低危、中危和高危患者7d内脑梗死的发生率分别为0、6.8%、32.4%,中危和高危脑梗死发生率明显高于低危患者,高危脑梗死发生率明显高于中危患者,差异有统计学意义(P<0.01);ABCD3-I评分与7d内脑梗死发生率呈正相关(r=0.486,P<0.01)。除年龄因素外,ABCD3-I评分法中各个评分项目对TIA后7d内脑梗死发生率均有明显影响(P<0.05)。结论 ABCD3-I评分法能更有效地预测TIA患者早期发生脑梗死的风险,可作为常规应用于临床,指导TIA危险分层评价和治疗。

Objective To study the application of ABCD^3-I score in predicting the risk of early ischemic stoke after transient ischemic attack（TIA）.Methods One hundred and eighty-two carotid TIA patients were divided into low risk group（n=40）,moderate risk group（n=74）and high risk group（n=68）according to their ABCD2,ABCD^3 and ABCD^3-I scores.The incidence of ischemic stroke was observed within 7days after TIA.Results The area under the ROC curve for ischemic stroke within 7days after TIA was 0.625,0.713 and 0.831,respectively.Twenty-seven patients（14.8%）developed ischemic stroke within 7days after TIA.The incidence of ischemic stroke was significantly higher in moderate and high risk groups than in low risk group and in high risk group than in moderate risk group（6.8% vs 0%,32.4% vs 0%,32.4% vs 6.8%,P〈0.01）.The ABCD^3-I socre was positively related with the incidence of ischemic stroke within 7days after TIA（r=0.486,P〈0.01）,suggesting that ABCD^3-I socre could significantly affect the incidence of ischemic stroke within 7days after TIA（P〈0.05）.Conclusion ABCD^3-I score can effectively predict the risk of early ischemic stroke after TIA,and can thus be used in assessment and treatment of TIA.