ABCD^2评分结合头颈CTA血管成像对短暂性脑缺血发作后早期发生脑梗死的预测价值

Predictive Value on ABCD^2 Scale Combined with Head and Neck CTA for the Early Cerebral Infarction after Transient Ischemic Attack

目的:研究ABCD2评分联合头颈CT血管成像(CTA)检查对短暂性脑缺血(TIA)发作后早期发生脑梗死的预测价值。方法:选取2017年1月至2018年12月在石河子市人民医院就诊的TIA患者98例,按ABCD2评分法进行评分,头颈CTA检查结果判断颅内外动脉狭窄程度,比较ABCD2评分及不同程度颅内外动脉狭窄患者七天内脑梗死发生率及两种联合预测对TIA患者早期发生脑梗死的价值。结果:ABCD2评分法中,高危组七天内脑梗死的发病率最高,占26.32%,其次为中危组占11.43%,低危组占4.00%,差异有统计学意义(P<0.05);头颈CTA检查颅内外动脉狭窄TIA患者脑梗死发生率依次为重度>中度>轻度,狭窄程度与TIA后脑梗死发生有关(P<0.01);ABCD2评分≥4分且颅内外动脉狭窄≥50%组患者七天内脑梗死发生率为31.71%,明显高于ABCD2评分≥4分且颅内外动脉狭窄<50%组,差异有统计学意义(χ^2=9.473,P=0.002,P<0.05)。结论:ABCD2评分能够有效地预测TIA患者早期发生脑梗死的风险,结合头颈部CTA检查,可提高预测TIA患者发生早期脑梗死的准确性。

Objective:To investigate the predictive value of ABCD2 score combined with head and neck CT angiography(CTA)in early cerebral infarction after transient ischemic attack(TIA).Methods:98 TIA patients were selected in the Shihezi People's Hospital from January 2017 to December 2018.By using ABCD2 score method,the degree of intracranial and extracranial artery stenosis by head and neck CTA examination was determined,incidences of cerebral infarction in 7 day were compared by ABCD2 score and different degrees of intracranial and external artery stenosis in patients and the predictive value of the combined ABCD2 score and examination of CTA of early cerebral infarction after TIA in patients.Results:The ABCD2 scored method,the incidence of cerebral infarction in high-risk group in 7 day was the highest,the incidence of cerebral infarction was 26.32%,followed by moderate(11.43%)and low risk group(4.0%),the difference was statistically significant(P<0.05).The incidence of cerebral infarction in TIA patients with intracranial and extracrania artery stenosis by head and neck CTA examined,followed by severe>moderate>mild,and the degree of artery stenosis was related to the occurrence of cerebral infarction after TIA(P<0.01).The incidence of cerebral infarction in patients with ABCD2 score≥4 and intracranial and extracranial artery stenosis≥50%within 7 day was 31.71%,which was significantly higher than that in patients with ABCD2 score≥4 and intracranial and extracranial artery stenosis<50%,the difference was statistically significant(χ^2=9.473,P<0.05).Conclusion:ABCD2 score can effectively predict the risk of early cerebral infarction in patients with TIA.ABCD2 score combined with head and neck CTA examination can improve the accuracy of predicting early cerebral infarction in patients with TIA.