ABCD^2评分联合颈动脉超声对TIA进展为脑梗死的预测评估  

Value of ABCD^2 score combined with carotid ultrasound in the prediction of cerebral infarction after transient ischemic attack

作　　者：顾言[1] 陈建荣[1] 成静[2] GU Yah ＊ CHEN Jiau-rong CHENG Jin(Second Affiliated Hospital of Namong University, Nantong 226001, China)

机构地区：[1]南通大学第二附属医院老年科,江苏省南通市226001 [2]南通大学护理学院,江苏省南通市226001

出　　处：《实用医学杂志》2016年第18期2952-2955,共4页The Journal of Practical Medicine

基　　金：南通市卫生局青年科研基金项目(WQ2014014)

摘　　要：目的:评估ABCD^2评分联合颈动脉超声对短暂性脑缺血发作(transient ischemic attack,TIA)后7d内发生脑梗死(cerebral infarction,CI)的预测价值。方法 :收集2014年7月至2015年12月收治的133例TIA患者的临床及颈动脉超声资料。根据ABCD^2评分及超声结果将所有病例分组,分别比较各组间TIA后7 d内脑梗死的发生率。结果 :133例TIA患者7 d内进展为脑梗死者35例,占26.3%。低危组(0~3分)、中危组(4~5分)、高危组(6~7分)脑梗死发生率分别为7.1%、25.0%、40.0%,其中低危组与中危组及高危组脑梗死发生率比较差异有统计学意义(P<0.05)。颈动脉斑块组及颈动脉狭窄组患者脑梗死发生率分别为39.5%、75.0%,与对照组比较差异有统计学意义(P<0.05)。ABCD^2评分≥4分患者中,颈动脉超声异常组脑梗死发生率为38.4%,高于颈动脉超声正常组(15.6%)(P<0.05)。结论:ABCD^2评分是预测TIA后短期发生脑梗死的简单、有效的工具,将ABCD^2评分联合劲动脉超声能提高对脑梗死的预测价值。Objective To analyze the evaluation value of ABCD2 combined with carotid ultrasound on the prediction of cerebral infarction after transient ischemie attack. Methods The clinical data of 133 patients with TIA admitted from July 2014 to December 2015 were analyzed. We score patients according to the standard of ABCD2 score and carotid ultrasound. The incidence of cerebral infarction within 7 days was observed. Results In the 133 TIA patients 35（26.3%） progressed to cerebral infarction. The 7-day incidence of cerebral infarction was 7.1% in patients with an ABCD2 score of low risk （0-3）, 25% with a score of moderate risk（4-5）, and 40% with a score of high risk（6-7）. The difference of the incidence of cerebral infarction was significant between the low and moderate risk stratification（P 〈 0.05）. The 7-day incidence of cerebral infarction was 39.5% in patients with carotid plaque and 75.0% in patients with carotid stenosis, both higher than the control group （P 〈 0.05）. In the ABCD2 score ≥4 group, the incidence of cerebral infarction in the patients with abnormal carotid ultrasound was 38.4% ,significantly higher than the patients with normal carotid ultrasound （P 〈 0.05）. Conclusions The ABCD2 score is effective to predict short-term risk of cerebral infarction in the patients with TIA. Combination with carotid ultrasound can improve the predictive accuracy of 7- day risk of cerebral infarction after TIA.

关 键 词：短暂性脑缺血发作 脑梗死 ABCD^2评分 颈动脉超声 预测 

分 类 号：R743.3[医药卫生—神经病学与精神病学]