ABCD^2评分联合血浆同型半胱氨酸水平检测在短暂性脑缺血发作风险评估中的应用  

Application of ABCD^2 score combined with detection of plasma homocysteine levels in risk assessment of transient ischemic attack

作　　者：李静[1] 李长清[1] 

机构地区：[1]重庆市重钢总医院,重庆400081

出　　处：《中国医药导报》2016年第13期36-39,共4页China Medical Herald

摘　　要：目的探讨ABCD^2评分联合血浆同型半胱氨酸(Hcy)水平检测在短暂性脑缺血发作(TIA)风险评估中的应用效果。方法回顾性分析2013年1月~2015年1月重庆市重钢总医院80例TIA患者的临床资料,所有患者均采用ABCD^2评分对患者的病情进行分层,同时检测患者血浆Hcy水平,观察比较不同ABCD^2评分、血浆Hcy TIA7 d内脑梗死发生情况,绘制ROC分析不同检测方法预测TIA 7 d内脑梗死发生风险的曲线下面积(AUC)。结果随着ABCD^2评分升高,Hcy水平及TIA 7 d内脑梗死发生率均逐渐升高,ABCD^2评分高危和中危者Hcy水平及TIA 7 d内脑梗死发生率[高危:(19.82±4.74)μmol/L、40.0%;中危:(17.22±4.15)μmol/L、25.0%]均明显高于低危者[(10.58±3.43)μmol/L、9.5%],差异有统计学意义(P<0.05);ABCD^2评分中、高危者Hcy水平比较,差异无统计学意义(P>0.05),而TIA 7 d内脑梗死发生率差异有高度统计学意义(P<0.01)。随着Hcy水平的逐渐升高,TIA 7 d内脑梗死的发病率也逐渐升高,Hcy水平10~<15μmol/L及≥15μmol/L者TIA 7 d内脑梗死发生率(10.53%、73.68%)明显高于Hcy<10μmol/L者(4.35%)(P<0.05),Hcy≥15μmol/L者明显高于10~<15μmol/L者,差异有高度统计学意义(P<0.01)。ROC曲线分析结果显示,ABCD^2评分及ABCD^2联合Hcy水平检测预测TIA 7 d内脑梗死发生风险的AUC分别为0.749和0.893(P<0.05)。结论随着ABCD^2评分期Hcy水平升高,TIA 7 d内脑梗死发生率均逐渐升高,ABCD^2评分联合血浆Hcy水平检测在TIA后脑梗死风险评估中具有重要的应用价值。Objective To explore the application effect of ABCD^2 score combined with detection of plasma homocysteine（Hcy） levels in the risk assessment of transient ischemic attack（TIA）. Methods Clinical data of 80 patients with TIA from January 2013 to January 2015 in General Hospital of Chongqing Iron and Steel Company were analyzed retrospectively,all patients were given the ABCD^2 score, and plasma homocysteine levels of all patients were detected at the same time;incidence of patients with different levels of plasma homocysteine and ABCD^2 score was observed and compared, ROC curve was drawn and the AUC of different detection method were used to predict the risk assessment of brain infarction within 7 d after TIA. Results With the increasing of ABCD^2 score, Hcy levels and incidence of brain infarction within7 d after TIA increased, levels of Hcy and incidence of brain infarction within 7 d after TIA of patients with high and medium risk of ABCD^2 score [high risk：（19.82±4.74） μmol/L, 40.0%; medium risk：（17.22±4.15） μmol/L, 25.0%] were significantly higher than those of low risk [（10.58±3.43） μmol/L, 9.5%], the differences were statistically significant（P 〈0.05）;there was no statistically significant difference between patients with medium risk and high risk of ABCD^2score（P 〈0.05）,while within 7 d after TIA brain infarction incidence differences apparent, the difference was statistically significant（P 〈0.01）. With the rising of Hcy levels, incidence of brain infarction within 7 d after TIA also gradually increased,brain infarction incidence of patients with Hcy 10-15 μmol/L and ≥15 μmol/L（10.53%, 73.68%） was significantly higher than patients with Hcy10 μmol/L（P 〈0.05）, brain infarction incidence of patients with Hcy≥15 μmol/L was significantly higher than 10-15 μmol/L, the difference was statistically significant（P 〈0.01）. ROC curve analysis showed that, AUC of ABCD^2 score and ABCD^2 combined with detection of Hcy in risk prediction of brain i

关 键 词：短暂性脑缺血发作 同型半胱氨酸 ABCD2评分 脑梗死 风险评估 

分 类 号：R743.3[医药卫生—神经病学与精神病学]