短暂性脑缺血发作患者改良ABCD_2评分与颅内外动脉狭窄的关系  

Modified ABCD_2 scoring and intra-extra-cranial artery stenosis in patients with transient ischemic attack

作　　者：苏建华[1] 李美英[1] 夏峰[1] 汤华萍[1] 曹勇军[2] 

机构地区：[1]东南大学医学院附属马鞍山市人民医院神经内科,安徽马鞍山243000 [2]苏州大学附属第二医院神经内科,江苏苏州215004

出　　处：《皖南医学院学报》2017年第2期150-152,161,共4页Journal of Wannan Medical College

摘　　要：目的:探讨短暂性脑缺血发作患者改良ABCD2评分与颅内外动脉狭窄的关系。方法:将182例TIA患者根据改良ABCD2评分分为低危组(28例)、中危组(88例)、高危组(66例)3组,根据MRA/CTA/DSA将颅内外动脉狭窄程度分为无或轻度狭窄(狭窄<50%)、中度狭窄(狭窄50%~69%)、重度狭窄(狭窄70%~100%)。分析3组患者改良ABCD2评分与颅内外动脉狭窄特点的相关性。结果:高危组患者重度动脉狭窄的比例明显高于低危组和中危组,但其轻度动脉狭窄的比例较低危组和中危组低,差异有统计学意义(χ2=31.258,P<0.01)。高危组患者颅内-外串联动脉狭窄的比例高于低危、中危组,其单纯颅内动脉狭窄的比例较低危、中危组低,差异有统计学意义(χ2=12.260,P<0.05)。高危组患者多支动脉狭窄的比例高于低危、中危组,差异有统计学意义(χ2=10.997,P<0.05)。改良ABCD2评分法预测动脉狭窄≥50%的ROC曲线下面积(0.664)高于ABCD2评分法(0.580)。结论:随改良ABCD2评分级别的增高,动脉狭窄程度、颅内-外联合病变、多支动脉狭窄的比例增加。与ABCD2评分相比,改良ABCD2评分法预测动脉狭窄≥50%的准确性更高。Objective：To investigate the association of the age,blood pressure,clinical features,duration of symptoms and diabetes （ABCD2） scores with intracranial or extracranial artery stenosis in patients with transient ischemic attack （TIA）.Methods：182 patients with TIA were divided into low risk group （n=28）,moderate risk group（n=88） and high risk group （n=66） by the modified ABCD2 scoring.Then the patients were subgrouped into blank stenosis,mild stenosis （〈50%）,moderate stenosis （50%-69%） and severe stenosis （70%-100%） by the degree of intracranial or extracranial artery stenosis measured with computed tomographic angiography （CTA）,magnetic resonance angiography（MRA） or digital subtraction angiography（DSA）.The relationship was analyzed between properties of intracranial or extracranial artery stenosis and the scores on modified ABCD2.Results：Compared to the low to moderate risk groups,patients in the high risk group had more incidences of severe stenosis,yet fewer mild stenosis.The difference was significant （χ^2=31.258,P〈0.01）.The patients with high modified ABCD2 scores were more likely to have intracranial-extracranial artery stenosis than those with low to moderate ABCD2 scores,yet proportion of simple intracranial vascular stenosis was lower than the patients with low to moderate risk （χ^2=12.260,P〈0.05）.The proportion of patients in the high risk group with multiple vessel involvement was greater than those with low to moderate ABCD2 scoring （χ^2=10.997,P〈0.05）.By area under ROC to predict the stenosis greater than 50%,modified ABCD2 scoring was better than conventional ABCD2 scoring（0.664 vs.0.580）.Conclusion：The extent of intracranial or extracranial stenosis,combined intracranial-extracranial artery stenosis and the incidence of multi-vessel involvement appears to increase with upward modified ABCD2 scoring,and modified ABCD2 scoring is superior to conventional ABCD2 scores in predicting intracranial-extracranial artery stenosis �

关 键 词：短暂性脑缺血 改良ABCD2评分 颅内外动脉狭窄 

分 类 号：R743.3[医药卫生—神经病学与精神病学]