ABCD、ABCD2和ABCD3评分法预测TIA患者发生脑梗死风险的比较研究  

The comparative study for predictive value of ABCD,ABCD2, ABCD3 score in in patients with TIA and the risk of stroke following a TIA

作　　者：赵振强[1] 胡兰[2] 蔡美华[1] 陈志斌[1] 王淑荣[1] 王埮[1] 陈小武[1] 

机构地区：[1]海南医学院附属医院神经内科,海南海口570102 [2]海南医学院附属医院检验科,海南海口570102

出　　处：《中国现代医学杂志》2014年第28期51-54,共4页China Journal of Modern Medicine

基　　金：海南省自然科学基金(No:811217);海南医学院科研培育基金(No:HY2010-025)

摘　　要：目的利用ABCD评分系统(ABCD、ABCD2和ABCD3评分法)对TIA患者短期内发生脑梗死的风险进行评估,评价3种评分法在临床应用价值。方法收集近3年来该院住院治疗的记录完整126例以TIA为首发症状的患者(发病后24 h内住院)的临床资料,按照加ABCD评分法、ABCD2评分和ABCD3评分法,分别对126例患者进行评分,观察7 d内、30 d内、90 d内脑梗死的发病率,并评价3种评分法对TIA患者发生脑梗死风险的预测价值。结果在该研究组中,TIA患者就诊后90 d内共25例(19.8%)发生脑梗死。其中,7 d内发生脑梗死18例(14.3%);30 d内发生脑梗死22例(17.5%);预测7 d内脑卒中风险时,ABCD评分、ABCD2评分和ABCD3评分法的ROC曲线下面积分别为0.693、0.696和0.711;预测30 d内脑卒中风险时,3种评分法ROC曲线下面积分别为0.671、0.705和0.754;预测90 d内脑卒中风险时,3种评分法ROC曲线下面积分别为0.696、0.779和0.862。ABCD评分法、ABCD2评分法和ABCD3评分法的阳性预测值,7 d内分别为:28.5%、27.9%和28.5%;30 d内分别为:27.6%、30.8%和34.6%;90 d内分别为:25.7%、27.8%和50.9%。结论对TIA患者7 d内发生脑梗死的风险评估,ABCD、ABCD2和ABCD3评分法之间的预测价值无明显差异;对30 d和90 d内的风险评估价值,ABCD3>ABCD2>ABCD。【Objectives】To accessthe predictive short-term stroke risk of the ABCD score system（ABCD,ABCD2, ABCD3） in patients with TIA（Transient Ischemic attack）, and then compare the clinical predictive value.【Methods】Data were collected from patients with transient ischemic attack within 24 hours of symptom onset from2009 to 2012, all 126 patients with complete clinical data were evaluated according ABCD, ABCD2, ABCD3 score in 7, 30 and 90 days respectively, and the positive predictive value of 4 scores were compared. 【Results】In this study, a total of 25 cases（19.8%） occurred cerebral infarction within 90 days. The 7-day risk of stroke was 14.3%,the 30-day risk of stroke was 17.5% in 126 patients. When the occurrences of cerebral infarction were observed in7 days, the area under the curve（AUCs） of ABCD, ABCD2, ABCD3 were 0.693,0.696,0.711; in 30 days the AUCs were 0.671,0.705,0.754; in 90 days the AUCs were 0.696,0.779,0.862. The 7-day positive predictive values of ABCD, ABCD2 and ABCD3 criteria were 28.5%, 27.9%, 28.5%; the 30-day ones were 27.6%, 30.8%, 34.6%; the30-day ones were 25.7%, 27.8%, 33.3%, 50.9%. 【Conclusion】The predictive values of ABCD, ABCD2, ABCD3score for short-term stroke in patients with TIA have no obvious difference within 7 days; The predictive accuracy of the ABCD3 score is superior to the others within 30 and 90 days.

关 键 词：短暂性脑缺血发作 脑梗死 ABCD评分法 ABCD2评分法 ABCD3评分法 

分 类 号：R743.3[医药卫生—神经病学与精神病学]