ABCD^2评分和高敏C反应蛋白对短暂性脑缺血发作患者脑梗死风险的早期预测  

Role of combined ABCD^2 score and hs-CRP in early prediction of risk factors for ischemic stroke following transient ischemic attack

作　　者：秦伟[1] 杨磊[1] 张晓丹[1] 胡文立[1] 

机构地区：[1]首都医科大学附属北京朝阳医院神经内科,100020

出　　处：《中华老年心脑血管病杂志》2015年第5期466-468,共3页Chinese Journal of Geriatric Heart,Brain and Vessel Diseases

基　　金：北京市卫生局资助项目(2009-3-09)

摘　　要：目的探讨ABCD2评分结合高敏C反应蛋白(hs-CRP)预测短暂性脑缺血发作(TIA)患者早期脑梗死风险的价值。方法选择临床诊断为TIA的患者192例,根据ABCD2评分分为低危组113例和中高危组79例,收集患者的一般临床资料及实验室检查结果,分析不同组别7、90d脑梗死的发生情况。根据hs-CRP水平又将患者分为≤3.0mg/L 149例和>3.0mg/L 43例,分析7、90d脑梗死的发生情况。应用ROC曲线分析计算曲线下面积(AUC)评价ABCD2评分分组、hs-CRP分法和两者结合分层预测脑梗死的价值。结果中高危组hs-CRP水平较低危组明显升高(P<0.01)。低危组与中高危组7d内分别有0例和24例(30.4%)发生了脑梗死,90d内分别有5例(4.4%)和33例(41.8%)发生了脑梗死(P<0.01)。预测7d内脑梗死发生风险时,ABCD2评分危险分组和hs-CRP分法及两者结合分层的AUC分别为0.836、0.777和0.928,预测90d脑梗死发生风险的AUC分别为0.785、0.803和0.903(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。Objective To study the role of combined ABCD2 score and hs-CRP in early prediction of risk factors for ischemic srtoke following transient ischemic attack（TIA）.Methods One hundred and ninety-two TIA patients were divided into low risk group（n=113）and moderate-high risk group（n=79）according to their ABCD2 score.Their clinical data and laboratory findings were recorded.The incidence of ischemic stroke was observed in two groups on days 7and 90 after TIA.The patients were further divided into hs-CRP≤3.0mg/L group（n=149）and hs-CRP3.0m/L group（n=43）.The incidence of ischemic stroke was observed in two groups on days 7and 90 after TIA.The ABCD2 scores in two groups were evaluated according to the AUC calculated using the ROC.The role of combined ABCD2 score and hs-CRP in early prediction of risk factors for ischemic srtoke was assessed.Results The serum hs-CRP level was significantly higher in moderate-high risk group than in low risk group.Ischemic stroke occurred in 0case and 24cases（30.4%）,and in 5cases（4.4%）and 33cases（41.8%）in low risk group and moderate-high risk group on days 7and 90 respectively after TIA（P〈0.01）.The AUC was 0.836,0.777,0.928 and 0.785,0.803,0.903 respectively when combined ABCD^2 score and serum hs-CRP level was used to predict the risk factors for ischemic stroke on days 7and 90 after TIA（P〈0.05）.ConclusionABCD2 score can accurately predict the risk factors for ischemic stroke in TIA patients.

关 键 词：C反应蛋白质 脑缺血发作 短暂性 脑梗死 ROC曲线 

分 类 号：R743.3[医药卫生—神经病学与精神病学]