ABCD3-I评分联合炎性和凝血指标检测对短暂性脑缺血发作近期发生脑梗死的预测

Value of ABCD3-I score combined with serum sCD40L and Fib levels for predicting cerebral infarction occurred within 90 days following TIA

目的探讨ABCD3-I评分结合血清可溶性CD40配体(sCD40L)和血浆纤维蛋白原(Fib)检测对短暂性脑缺血发作(TIA)患者90d内发生脑梗死的预测价值。方法连续选取首次发病的TIA患者178例,随访90d,将发展为脑梗死的27例患者作为脑梗死组,未发展为脑梗死的151例患者作为对照组。入选者均进行ABCD3-I评分,采用酶联免疫吸附法检测sCD40L和Fib水平,绘制ROC曲线分析相关指标的预测价值。结果与对照组比较,脑梗死组ABCD3-I评分和sCD40L及Fib水平明显升高[(6.17±1.04)分vs (5.43±1.32)分,P=0.009;(222.00±28.75)μg/L vs (187.80±35.47)μg/L,P=0.014;(4.01±1.52)g/L vs (3.55±1.26)g/L,P=0.012]。ROC曲线分析显示,ABCD3-I评分联合sCD40L、ABCD3-I评分联合Fib、ABCD3-I评分联合sCD40L和Fib预测TIA患者90d内发展为脑梗死的曲线下面积分别为0.656(95%CI:0.586~0.732,P=0.001)、0.680(95%CI:0.615~0.745,P=0.000)和0.714(95%CI:0.654~0.774,P=0.000),均有预测价值,且ABCD3-I评分联合sCD40L和Fib的预测价值较前两者更高,其敏感性为90.1%,特异性为88.2%。结论 ABCD3-I评分联合sCD40L和Fib检测可进一步提高预测TIA患者90d内发展为脑梗死的准确率,且预测价值较高。

Objective To study the value of ABCD3-I score combined with serum sCD40 Land Fib levels for predicting cerebral infarction occurred within 90 days following TIA.Methods One hundred and seventy-eight TIA patients who were followed up for 90 days were divided into cerebral infarction group(n=27)and control group(n=151).The patients were scored according to the ABCD3-I Scale.Their serum sCD40 Land Fib levels were measured by ELISA.The value of ABCD3-I score combined with sCD40 Land Fib levels for predicting cerebral infarction following TIA was analyzed by ROC curve analysis.Results The ABCD3-I score and serum sCD40 Land Fib levels were significantly higher in cerebral infarction group than in control group(6.17±1.04 vs 5.43±1.32,P=0.009;222.00±28.75μg/L vs 187.80±35.47μg/L,P=0.014;4.01±1.52 g/L vs 3.55±1.26 g/L,P=0.012).The area under the ROC curve for ABCD3-I score combined with sCD40 L,ABCD3-I score combined with Fib levels,ABCD3-I score combined with sCD40 Land Fib levels in TIA patients were 0.656(95%CI:0.586-0.732),0.680(95%CI:0.615-0.745),0.714(95%CI:0.654-0.774).ABCD3-I score combined with sCD40 Land Fib levels with a sensitivity of 90.1% and a specificity of 88.2%(P =0.000).Conclusion ABCD3-I score combined with sCD40 Land Fib levels is of a high value for predicting cerebral infarction and can thus further improve the protective accuracy for cerebral infarction in TIA patients.