ABCD3模型预测短暂性脑缺血发作后早期卒中风险  

Validation of ABCD3 score in the predication of stroke risk after transient ischemic attack

作　　者：王元元[1] 宋波[1] 方慧[1] 赵璐[1] 谈颂[1] 高远[1] 徐雅芳[1] 许予明[1] 孙石磊[1] 

机构地区：[1]郑州大学第一附属医院神经内科,450052

出　　处：《中华医学杂志》2013年第43期3424-3427,共4页National Medical Journal of China

基　　金：河南省卫生厅重点科技攻关项目（201202005）;河南省教育厅项目（12A320046）

摘　　要：目的 评价ABCD3对短暂性脑缺血发作（TIA）后早期卒中风险的预测价值,探讨影响TIA后早期卒中发生的危险因素.方法 连续纳入2010年10月至2012年9月入住郑州大学第一附属医院神经内科TIA患者,登记一般资料及7 d内ABCD2、ABCD3评分,观察90 d内卒中发生率,采用Logistic回归分析影响TIA后早期卒中发生的危险因素,两种评分的预测价值比较采用接受者操作特性曲线 （ROC曲线）.结果 共纳入321例TIA患者,其中4例失访,90 d后有38例（11.8%）发生卒中,其中男22例（57.9%）,女16例（42.1%）,无死亡患者,无出血性卒中的发生.多因素分析结果显示,7 d内TIA发作超过2次（OR=4.116,95%CI 1.284～3.195）、脑梗死病史（OR=4.022,95%CI 1.472～10.944）、单侧肢体无力（OR=3.117,95%CI 1.222～7.948）是短期内进展至脑梗死的危险因素.ABCD3评分下面积（0.733,95%CI 0.681～0.780）明显高于ABCD2（0.674,95%CI 0.619～0.725）（P〈0.05）.结论 ABCD3能有效预测TIA后早期卒中风险.Objective To explore the evaluation of ABCD3 score in the prediction of stroke risk after transient ischemic attack and the influencing factors of early stroke risks. Methods From October 2010 to September 2012, the data were prospectively collected from patients with transient ischemie attack according to the World Health Organization time-based criteria. ABCD2 and ABCD3 scores were available within 7 days of index transient ischemic attack. The predictive outcome was stroke occurrence at 90 days. Risks of stroke stratified according to the score were analysed by Logistic regression. And ABCD2 and ABCD3 model were compared by AUROCC. Results Among 321 eligible patients, 4 cases were lost to follow-up. There were 38（ 11.8% ） patients with ischemic stroke during a 90-day follow-up, including 22 （57.9%） males, 16 （42. 1% ） females. There were no occurrence of death, no hemorrhagic stroke. Multivariate analysis revealed that dual TIA （ OR = 4. 116, 95 % CI 1. 284 - 3.195 ）, history of stroke （ OR = 4. 022, 95% CI 1. 472 - 10. 944） and unilateral weakness （ OR = 3.117, 95% C1 1. 222 - 7. 948 ） were the risk factors of early stroke. The ABCD3 score （0. 733, 95% CI,0. 0. 681 -0. 780） was statistically higher than that of ABCD2 score （ 0. 674, 95% CI, 0. 619 - 0. 725 ） （ P 〈 0.05 ）. Conclusion ABCD3 may effectively predict early risk of stroke after TIA.

关 键 词：脑缺血发作 短暂性 卒中 ABCD3 风险 

分 类 号：R743.3[医药卫生—神经病学与精神病学]