急性轻型卒中早期ABCD3-I评分与病情转归的关系

Relationship between ABCD3-I score and outcome in patients with acute minor ischemic stroke

目的:观察ABCD3-I评分在预测急性轻型卒中病情转归中的价值。方法:分别采用ABCD、ABCD2、ABCD3、ABCD3-I与ESSEN评分标准对255例轻型卒中患者进行评分,记录性别、年龄、梗死部位、高血压、糖尿病、心脏及血管疾病、临床症状、责任颈动脉狭窄、DWI异常信号等与各评分相关的因素,并观察患者预后和早期加重的情况。结果:255例患者中,90 d内转归不良的患者48例。单因素分析显示转归不良组与转归良好组间高血压、糖尿病、心脏及血管疾病、临床症状、责任颈动脉狭窄、DWI异常信号差异存在统计学意义(P<0.05)。ABCD、ABCD2、ABCD3、ABCD3-I与ESSEN评分预测轻型卒中转归不良的风险的ROC曲线下面积(AUC)分别为0.791 0、0.798 3、0.827 9、0.930 0和0.735 9。不同严重程度ABCD3-I评分组转归不良和早期进展差异有统计学意义。结论:ABCD3-I评分法可以预测急性轻型卒中的转归,为个性化治疗提供了新的工具。

Objective To investigate the value of ABCD3-I score in predicting the outcome of acute minor ischemic stroke. Methods Totally 255 patients were valued by ABCD, ABCD2, ABCD3, ABCD3-I and ESSEN score then the clinical characters, outcome and early progression of these patients were investigated. Results Forty-eight patients had poor outcome after 90 days. Univariate logistic regression indicated that the differences of hypertension, diabetes, cardiovascular disease, stenosis of criminal artery, abnormal signal in diffusion weighted imaging （DWI） and other clinical symptoms between poor outcome group and good outcome group were statistically significant （P 〈 0.05）. The AUC of ABCD, ABCD2, ABCD3, ABCD3-I and ESSEN score in predicting outcome of acute minor stroke was 0.791 0, 0.798 3, 0.827 9, 0.930 0 and 0.735 9 respectively. There was difference among patients with different ABCD3-I scores both in outcome and early progression. Conclusion ABCD3-I score can predict the outcome of acute minor stroke and supply a new method for personalized treatment.