ABCD^2评分法和ABC^2D^2评分法对短暂性脑缺血发作后卒中风险的预测价值比较

Comparative study of ABCD^2 and ABC^2D^2 in predicting risk of stroke after transient ischemic attack

目的探讨ABCD^2评分法和ABC^2D^2评分法对短暂性脑缺血发作(TIA)后卒中风险的预测价值。方法分别按照ABCD^2评分、ABC^2D^2评分法将安徽医科大学附属宿州市立医院2014年3月~2016年9月收治的139例TIA患者分为低危、中危、高危三组,并观察7 d、1年之内的脑卒中发生率,评价两种评分对TIA患者进行卒中风险的分层能力;通过ROC曲线下面积比较两种评分对TIA后7 d、1年内发生脑卒中风险的预测价值。结果按ABCD2评分分为低危组(0~3分)37例、中危组(4~5分)86例和高危组(6~7分)16例,其7 d内发生脑卒中风险概率分别为5.41%、26.74%和56.25%,其1年内发生脑卒中风险概率分别为13.51%、40.70%和68.75%,差异均有统计学意义(P<0.05)。按ABC^2D^2评分分为低危组(0~3分)24例、中危组(4~6分)78例和高危组(7~9分)37例,其7 d内发生脑卒中风险概率分别为0.00%、16.67%和56.76%,其1年内发生脑卒中风险概率分别为4.17%、30.77%和70.27%,差异均有统计学意义(P<0.05)。ABC^2D^2评分法预测TIA患者7 d(1年)内脑卒中风险的ROC曲线下面积均高于ABCD^2,差异均有统计学意义(P<0.05)。结论 ABC^2D^2评分法的预测价值高于ABCD^2评分法,是预测TIA后卒中风险的一种比较有效的方法。

Objective To explore the predictive value of ABCD2 criteria and ABC2D2 criteria method for stroke risk in transient ischemic attack （TIA）. Methods One hundred and thirty-nine patients with TIA from March 2014 to September 2016 in Suzhou Municipal Hospital Affiliated to Anhui Medical University were divided into low risk, moderate risk and high risk group according to ABCD2 and ABC2D2 criteria, the incidence of stroke in 7 d and 1 year was observed. The stratification of the risk of stroke risk in patients with TIA was evaluated. The prediction value of the risk of stroke in 7 d, 1 year after TIA was compared under the ROC curve （AUC）. Results According to the ABCD2 criteria, the patients were divided into 37 cases of low-risk group （0-3 points）, 86 cases of middle-risk group （4-5 points） and 16 cases of high-risk group （6-7 points）. The risk of stroke in 7 days was 5.41%, 26.74% and 56.25%, the risk of stroke in 1 year was 13.51%, 40.70% and 68.75%, the differences were statistically significant （P ＜ 0.05）. According to the ABC2D2 criteria, the patients were divided into 24 cases of low-risk group （0-3 points）, 78 cases of middle-risk group （4-6 points） and 37 cases of high-risk group （7-9 points）. The risk of stroke in 7 d was 0.00%, 16.67% and 56.76%, the risk of stroke in 1 year was 4.17%, 30.77% and 70.27%, the differences were statistically significance （P ＜ 0.05）. ABC2D2 criteria were used to predict that the area of the ROC curve of the risk of stroke in patients with TIA in 7 d （1 year） was higher than that of ABCD2, the differences were statistically significance （P ＜ 0.05）. Conclusion The prediction value of ABC2D2 criteria is higher than that of the ABCD2 scoring method, which is a more effective method to predict the risk of stroke after TIA.