同型半胱氨酸联合ABCD^2对短暂性脑缺血发作预后判断的应用  

The Application of the Homocysteine Combination With ABCD^2 to the Prognosis of Transient Ischemic Attack

作　　者：黄国峰[1] 王东伟[1] 陈会元[1] 徐艳梅[1] 刘爽[1] 

机构地区：[1]黑龙江省医院南岗院区神经内二科,黑龙江哈尔滨150001

出　　处：《中国卫生标准管理》2017年第10期54-55,共2页China Health Standard Management

基　　金：黑龙江省卫生计生委科研课题(2014-161)

摘　　要：目的评价ABCD^2评分预测TIA患者进展为脑梗死的应用,同时评估联合同型半胱氨酸血症(Hcy)对TIA患者脑梗死发生率的影响。方法测定198例TIA患者的ABCD^2评分值、同型半胱氨酸值、进展脑梗死的发生率。分析不同评分的TIA患者的脑梗死率差别,并分析高Hcy对TIA患者脑梗死发生率的影响。应用ROC曲线分析计算曲线下面积(AUC)评价ABCD2评分及其与Hcy结合预测TIA进展脑梗死的价值。结果 (1)评分≤3分的TIA患者有37例,发生脑梗死者3例(8%);(2)评分4或5分的患者总共105例,发生脑梗死者22例(21%);(3)评分≥6分的患者总共56例,脑梗死者22例(39%)。TIA患者的不同ABCD^2评分值的脑梗死发生率的差异均有统计学意义(P<0.05)。高Hcy为脑梗死的危险因素,两组TIA患者的脑梗死发生率的差别有统计学意义(P<0.05)。ABCD^2联合Hcy评分法和ABCD2评分法的曲线下面积(AUC)分别为0.815(0.679~0.899)和0.764(0.625~0.863)。结论 TIA患者不同的ABCD^2评分值脑梗死的发生率不同,分值越高,发生率越高,高Hcy为TIA进展脑梗死的危险因素。ABCD^2联合Hcy评分标准是临床上预测TIA短期进展为脑梗死的一种比较有效的方法。Objective Evaluating the ABCD2 scoring method for the prediction of the progress of TIA to the cerebral infarction in hospitalized patients and the effects of hyperhomocysteinemia （Hcy） on the incidence rate of cerebral infraction in TIA patients. Methods The ABCD2 score, basic clinical features, and incidence rate of cerebral infarction were measured for 198 hospitalized T1A patients. The difference of cerebral infarction rates between TIA patients with different scores and to analyze the effect of Hcy on the incidence rate of cerebral infarction in TIA patients were analysed. The area under the curve （AUC） was calculated by ROC curve to evaluate the ABCD2 scoring and its combination with Hcy to predict the progress of cerebral infarction in TIA patients. Results （1）37 TIA patients with score ~〈 3, 3 cerebral infarction （8%）. （2）105 TIA patients with score=4 or 5, 22 cerebral infarction （8%）. （3）56 T1A patients with score 〉I 6, 22 cerebral infarction （39%）. The variation of the incidence rates of cerebral infarction of TIA patients with different ABCD2 scores is statistically significant （P 〈 0.05）. Hcy is the risk factor of cerebral infarction and the variation of incidence rate of cerebral infarction in the two groups of TIA patients is statistically significant （P 〈 0.05）. The scoring method of the combination ofABCD2 and Hcy and the area under the curve （AUC） by ABCD2 scoring are respectively 0.815 （0.679 - 0.899） and 0.764 （0.625 ~ 0.863）. Conclusion The incidence rates of cerebral infarction in TIA patients with different ABCD2 scores are different. The higher the score, the higher the incidence rate. The combination ofABCD2 scoring with Hcy is an effective method for predicting the short-term cerebral infarction progress of TIA patients.

关 键 词：短暂性脑缺血发作 脑梗死 ABCD2联合同型半胱氨酸评分法预测 

分 类 号：R651[医药卫生—外科学]