ABCD^(3)量表结合同型半胱氨酸及头颅MRA对短暂性脑缺血发作短期预后评估

ABCD^(3) scale combined with homocysteine assay and cranial MRA for short-term prognosis evaluation of transient ischemic attack

目的分析ABCD^(3)量表结合同型半胱氨酸及头颅MRA对TIA短期脑卒中风险的预测。方法选取2018年7月1日至2019年7月1日于温岭市第一人民医院就诊的120例TIA患者,对入组病例进行7、30、180 d随访,采用ABCD^(3)评分、ABCD^(3)-I评分及ABCD^(3)-I评分法联合血清同型半胱氨酸(ABCD^(3)-HI)进行ROC曲线下面积(AUC)分析,进而对其预测再发卒中的价值进行评估。结果ABCD^(3)-HI评分对TIA发作后7、180 d内发生脑卒中的AUC分别为0.913、0.917,高于ABCD^(3)-I评分及ABCD^(3)评分(0.895、0.906)、(0.857、0.809)。ABCD^(3)-HI评分及ABCD^(3)-I评分对TIA发作后30 d内发生脑卒中的AUC分别为0.907及0.913,两种方法均高于ABCD^(3)评分的0.831。结论ABCD^(3)-HI评分具有较好的预测TIA发作后再发脑卒中的价值。

Objective To analyze the prediction of the short-term stroke risk of transient ischemic attack(TIA)by the ABCD^(3) scale combined with homocysteine assay and cranial magnetic resonance angiography(MRA).Methods A total of 120 TIA patients who attended the First People′s Hospital of Wenling City from July 1,2018 to July 1,2019 were selected.The patients were followed up at 7,30,and 180 days.The ABCD^(3) scoring,the ABCD^(3)-I scoring and the ABCD^(3)-I scoring combined with serum homocysteine assay(ABCD^(3)-HI scoring)were used to analyze the area under the receiver operating characteristic(ROC)curve(AUC),so as to evaluate their predictive value for stroke risk.Results The ABCD^(3)-HI scores were 0.913 and 0.917 for the AUC of stroke prediction within 7 days and 180 days after the onset of TIA,which were higher than the ABCD^(3)-I scores(0.895,0.906)and ABCD^(3) scores(0.857,0.809).The ABCD^(3)-HI score and ABCD^(3)-I score for the AUC of stroke prediction within 30 days after the onset of TIA were 0.907 and 0.913,respectively,and the scores obtained by both methods were higher than the ABCD^(3) score of 0.831.Conclusion The ABCD^(3)-HI score has a good predictive value for the occurrence of stroke after the onset of TIA.