ABCD^2评分结合磁共振弥散加权成像对TIA后脑梗死风险的早期预测  

Early prediction with ABCD^2 score and magnetic resonance diffusion-weighted imaging for stroke risk after transient ischemic attack

作　　者：梅飞来 秦伟[2] 张晓丹[2] 胡文立[2] 

机构地区：[1]北京航天总医院神经内科,100076 [2]首都医科大学附属北京朝阳医院

出　　处：《中国民康医学》2014年第18期4-5,32,共3页Medical Journal of Chinese People’s Health

摘　　要：目的:探讨ABCD2评分结合磁共振弥散加权成像(DWI)用于短暂性脑缺血发作(TIA)患者脑梗死风险的早期预测价值。方法:选取166例临床诊断为TIA的患者,根据ABCD2评分分为低危组75例,中危组60例,高危组31例;同时依据DWI结果将患者又分为DWI异常组96例和DWI正常组70例,随访TIA患者后2d、7d和90d内的脑梗死发生率。结果:患者TIA后第2天、第7天和第90天脑梗死率分别为7.8%、11.4%和15.7%。与低危组比较,ABCD2评分≥4分的中危组和高危组患者脑梗死发生率明显增高,差异有统计学意义(P<0.05)。ABCD2评分≥4且DWI异常组患者脑梗死发生率明显高于其他组,差异有统计学意义(P<0.05)。结论:ABCD2评分法早期预测TIA患者脑梗死风险的准确性较高,结合DWI检查结果能进一步提高预测准确性。Objective：To study the value of combined ABCD2 score and magnetic resonance diffusion - weighted imaging （DWI） to early predict cerebral infarction risk in transient ischemic attack （TIA） patients. Methods：166 clinical diagnosed TIA pa-tients were divided into low risk group （n=75）, moderate risk group （n=60） and high risk group （n=31） according to their ABCD2 scores. The patient were further divided into DWI positive group （n=96） and DWI negative group （n=70） according to the DWI find-ings. The incidence of cerebral infarction was observed 2, 7 and 90 days after the presence of TIA. Results： The incidence of cerebral infarction after the presence of TIA on day 2, 7 and 90 was 7. 8% , 11. 4% and 15. 7% , respectively. The incidence of cerebral in-farction after TIA was significantly higher in moderate and high risk group than that in low risk group （P〈0. 05）. The incidence of cer-ebral infarction in patients with ABCD2 score ≥4 and acute infarct on diffusion weighted imaging was significantly higher than that in other groups （P〈0. 05）. Conclusions： The ABCD2 score is effective in the early prediction of cerebral infarction risk in the patients with TIA. Combination with DWI can further improve the predictive accuracy.

关 键 词：短暂性脑缺血发作 脑梗死 ABCD2 评分 磁共振弥散加权成像 

分 类 号：R743.31[医药卫生—神经病学与精神病学]