应用ABCD^2评分预测短暂性脑缺血发作患者早期复发事件严重程度的研究  

ABCD^2 Score Predicts Severity of Early Recurrent Events,After Transient Ischemic Attack

作　　者：李玲[1] 张锦丽[1] 宋杨[1] 

机构地区：[1]北京军区总医院263临床部神经内科,北京市101149

出　　处：《中国卒中杂志》2011年第7期533-538,共6页Chinese Journal of Stroke

摘　　要：目的评估ABCD^2评分在短暂性脑缺血性发作(transient ischemic attack,TIA)患者中预测早期卒中复发严重程度的效度。方法前瞻性地连续纳入488例发病48小时内的TIA住院患者。对患者进行ABCD^2评分,观察发病7天内患者的复发事件,包括TIA复发,大卒中[美国国立卫生院神经功能缺损评分(National Institute ofHealth stroke scale,NIHSS)>3]和小卒中NIHSS≤3发生情况。采用曲线下面积(area under the receiveroperating characteristic curve,AUC)值评估ABCD^2预测TIA患者复发和新发卒中事件严重程度的价值。结果本研究收集488例发病48小时内的TIA住院患者中,在7天内49例(10.04%)患者复发TIA[95%可信区间(confidence interval,CI)为6.78%～1 6.12%],48例卒中,其中小卒中23例(4.71%;95%CI 1.96%～6.37%),大卒中25例(5.1 2%;95%CI 2.68%～8.08%)。ABCD^2评分预测大卒中发生效度高(AUC=0,76;95%CI 0.67～0.85,P<0.01),预测小卒中发生效度较低(AUC=0.57;95%C/0.42～0.70,P=0.18),ABCD^2评分高低与TIA复发风险呈反比(AUC=0.34,95%CI 0.22～0.59,P<0.01),3组间AUC值比较差异有统计学意义(均P<0.01)。结论 ABCD^2评分能对TIA患者早期复发和新发卒中严重程度进行预测。Objective To assess the predictive accuracy of the ABCD^2 score for the severity of early recurrent events after transient ischemic attack （TIA）. Methods We completed a prospective, hospital-based study of 488 consecutive patients presenting with TIA. Recurrent TIA, minor stroke, and major stroke （National Institutes of Health Stroke Scale score〉3） were identified within 7 days after TIA. Predictive value was expressed as the area under the receiver operating characteristic curve （AUC）. Results Of 488 patients with TIA were involved in study, 49 had a recurrent TIA （10.04%; 95%CI, 6.78% to16.12%）, 23 had a recurrent minor stroke （4.71%; 95%CI, 1.96% to 6.37%） and 25 had a recurrent major stroke （5.12%; 95%CI, 2.68% to 8.08%） within 7 days. The ABCD2 score was highly predictive of major recurrent stroke （AUC=0.76; 95%CI,0.67 to 0.85, P〈0.01）, weakly predictive of minor stroke （AUC=0.57; 95%CI, 0.42 to 0.70, P=0.18）, and inversely related to risk of recurrent TIA （AUC=0.34; 95% CI, 0.22 to 0.59, P〈0.01 ） （overall heterogeneity, P〈0.001）. Conclusion The ABCD2 score predicts severity of recurrent events after TIA, high scores being associated with major recurrent stroke and low scores with high rates of recurrent TIA.

关 键 词：脑缺血发作 短暂性 ABCD^2 评分 预测 危险因素 

分 类 号：R743[医药卫生—神经病学与精神病学]