应用ABCD^2评分法和纤维蛋白原预测TIA后短期脑卒中风险  

Early stroke risk prediction after transient ischemic attack with ABCD^2+Fib score

作　　者：王为强[1] 任明山[1] 杨毅[1] 

机构地区：[1]安徽医科大学附属省立医院,安徽省立医院神经内科,合肥硕士研究生230001

出　　处：《卒中与神经疾病》2009年第2期98-101,共4页Stroke and Nervous Diseases

摘　　要：目的探讨ABCD2+纤维蛋白原评分法对短暂性脑缺血发作后7d内发生脑梗死的预测价值。方法用ABCD2评分法和ABCD2+纤维蛋白原评分法分别测定135例TIA患者的评分,并观察TIA后7d内脑梗死的发生率。结果ABCD2+纤维蛋白原评分法和ABCD2评分法的曲线下面积(95%CI)分别为0.755(0.668~0.842)和0.711(0.618~0.804)。135例TIA患者中≤2分者13例,脑梗死的发生率为零;评分为3分者12例,脑梗死的发生率为8%;评分为4分者30例,脑梗死的发生率为17%;评分为5分者40例,脑梗死的发生率为25%;评分为6分者28例,脑梗死的发生率54%;评分≥7分者12例,脑梗死的发生率为58%。低危(0~3分)、中危(4~5分)和高危(6~8分)组TIA后7d内发生脑梗死的比例分别为4%、21%和55%(P<0.05)。结论ABCD2+纤维蛋白原评分法的预测价值高于ABCD2评分法。ABCD2+纤维蛋白原评分标准是临床上预测TIA短期进展为脑梗死的一种比较有效的方法。Objective To explore the ability of ABCD^2＋ Fib score in predicting cerebral infarction of transient ischemic attack patients at 7th day. Methods 135 TIA patients were evaluated according to ABCD^2 criteria and ABCD^2 ＋ Fib criteria. The occurrences of cerebral infarction were observed in 7 days. Results The AUCs （95%CI） of ABCD^2＋ Fib and ABCD2 were 0. 755（0. 668-0. 842） and 0. 711 （0. 618-0. 81）4）. respectively 13 TIA patients scored 2 or less, and the occurrence of cerebral infarction was 0. 12 patients scored 3, and the occurrence was 8%. 30 patients scored 4, and the occurrence is 17%. 40 patients scored 5, and the occurrence was 25%. 28 patients scored 6, and the occurrence was 54%. 12 TIA patients scored 7 or more, and the occurrence was 58%. The 7-day risk of stroke was 4% in patients with an ABCD^2 score of low risk（0-3） ,21% with a score of moderate risk （4-5） ,and 55% with a score of high risk （648） （P〈0. 05）. Conclusions The predictive accuracy of the ABCD^2 ＋ Fib is significantly higher than that of ABCD^2. ABCD^2＋ Fib criteria is effective to predict the occurrence of cerebral infarction in short-term of TIA.

关 键 词：短暂性脑缺血发作 脑梗死 ABCD^2+纤维蛋白原评分法 预测 

分 类 号：R743[医药卫生—神经病学与精神病学]