ABCD2评分对前后循环短暂性脑缺血发作患者卒中风险的预测价值  

Predictive value of ABCD2 score for stroke risk following anterior or posterior circulation transient ischemic attack

作　　者：代齐良 孙文[1] 李敏[1] 

机构地区：[1]南京大学医学院附属金陵医院(南京军区南京总医院)神经内科,南京医学博士210002

出　　处：《医学研究生学报》2015年第11期1143-1147,共5页Journal of Medical Postgraduates

基　　金：国家自然科学基金(81220108008;31171016);江苏省自然科学基金(BK2011021)

摘　　要：目的 ABCD2评分用于预测短暂性脑缺血发作（transient ischemic attack,TIA）患者短期卒中风险已经过大量研究验证,并在临床中广泛使用;但对于ABCD2预测不同供血区TIA患者短期卒中风险的报道较少。本研究旨在分别探讨ABCD2评分对于前循环和后循环TIA患者短期卒中风险的预测价值。方法连续性纳入南京卒中注册系统中2011年9月至2012年12月明确诊断的TIA患者,按症状分为前循环和后循环TIA。收集患者各种危险因素并进行为期共90 d的随访。分别计算每位患者ABCD2评分,通过受试者工作特征曲线对预测90 d卒中风险的能力进行分析。结果研究共纳入204例患者,其中前循环TIA 143例、后循环TIA 61例。患者平均年龄（63.7±11.2）岁,其中女性59例（28.9%）。90 d发生的卒中前循环11.2%、后循环9.8%,组间比较差异无统计学意义（P=0.776）。患者平均ABCD2评分前循环（3.7±1.5）分、后循环（2.5±1.3）分,组间比较差异有统计学意义（P〈0.001）。ABCD2预测前循环卒中风险曲线下面积为0.711（95%CI：0.575-0.847,P=0.006）;预测后循环卒中风险的曲线下面积为0.559（95%CI：0.298-0.820,P=0.637）。结论 ABCD2评分对前循环TIA患者早期卒中风险具有较好的预测价值,而对于后循环TIA后卒中风险预测效能一般。Objective Many studies have proved that the ABCD2 score can be used to predict early stroke risk after transient ischemic attack（ TIA）,but few reports are seen on its predictive value for early stroke risk after TIA in different types of circulation.This article aimed to evaluate the ABCD2 score in predicting early stroke risk following anterior or posterior circulation TIA. Methods Patients with definitely diagnosed TIA consecutively included in Nanjing Stroke Registration System from September 2011 to December2012 were classified into anterior and posterior circulation TIAs. Various risk factors were collected and a 90-day follow-up was conducted. The ABCD2 score was obtained from each patient and its predictive value assessed using the receiver operating characteristic curve. Results A total of 204 patients were analyzed in the study,including 59（ 28. 9%） females,143 with anterior and 61 with posterior circulation TIA,aged 63. 7 ± 11. 2 years. There were no statistically significant differences in the incidence rate of stroke within 90 days between the anterior and posterior circulation TIAs（ 11. 2% vs 9. 8%,P = 0. 776）. The mean ABCD2 score was remarkably higher in the anterior than in the posterior circulation TIA（ 3. 7 ± 1. 5 vs 2. 5 ± 1. 3,P 〈0. 001）. The area under the curve（ AUC） in predicting stroke risk was 0. 711 for the former（ 95% CI： 0. 575- 0. 847,P = 0. 006） and 0. 555 for the latter（ 0. 298-0. 820,P = 0. 637）. Conclusion The ABCD2 score can predict early stroke risk in anterior but not in posterior circulation TIA.

关 键 词：短暂性脑缺血发作 卒中风险 预测 ABCD2评分 

分 类 号：R743[医药卫生—神经病学与精神病学]