ABCD3评分结合FIB、D-二聚体在预测短暂性脑缺血发作早期卒中风险的实用价值分析

Analysis of the practical value of ABCD3 score combined with FIB and d-dimer in predicting the risk of early stroke in transient ischemic attack

目的:探讨应用ABCD3评分系统联合血清纤维蛋白原(FIB)、D-二聚体预测短暂性脑缺血发作(TIA)早期卒中风险的价值。方法:回顾性分析诊断为TIA的98例患者的临床资料,所有患者均采集血清,行FIB与D-二聚体检测,此外对患者均应用ABCD3评分,统计7 d内脑卒中发生率,并根据脑卒中发生情况进行分组。结果:98例TIA患者中总计有14例(14.29%)发生脑卒中,脑卒中组患者血清FIB、D-二聚体水平均显著高于非脑卒中组,差异有统计学意义(P<0.05);ABCD3评分显示在脑卒中发生率上,高危组>中危组>低危组;对比分子ABCD3评分的各项危险因素,结果显示临床症状持续时间≥10 min、同侧颈动脉狭窄以及DWI检测发现异常高信号为早期卒中风险的危险因素,差异有统计学意义(P<0.05)。结论:TIA患者FIB、D-二聚体水平高者进展为脑卒中的风险明显增高,ABCD3评分高者进展为卒中的风险也明显升高,在TIA患者中,临床症状持续时间长、合并同侧颈动脉狭窄以及DWI检测信号异常的TIA患者均更易进展为脑卒中。

Objective To investigate the value of ABCD3 scoring system combined with serum fibrinogen(FIB)and d-dimer in predicting the risk of early stroke in TIA.Method The clinical data of 98 patients with TIA diagnosed by internal medicine in our hospital were retrospectively analyzed.Serum was collected from all patients for FIB and d-dimer detection.In addition,ABCD3 score was applied to the patients to calculate the incidence of stroke within 7 days,and the patients were grouped according to the incidence of stroke.Results Among the 98 patients with TIA,a total of 14 patients(14.29%)had cerebral apoplexy.The serum FIB and d-dimer levels of patients in the stroke group were significantly higher than those in the non-stroke group(P<0.05).ABCD3 score showed that in the incidence of stroke,the high risk group>medium risk group>low risk group;By comparing the risk factors of molecular ABCD3 score,the results showed that the clinical symptom duration 10 min,ipsilateral carotid artery stenosis and abnormal high signal detected by DWI were risk factors for early stroke(P<0.05).Conclusion Patients with TIA with high FIB and d-dimer levels have a significantly increased risk of developing stroke,and patients with high ABCD3 score also have a significantly increased risk of developing stroke.In patients with TIA,patients with long clinical symptom duration,combined with ipsilateral carotid artery stenosis and abnormal DWI detection signal are more likely to develop stroke.