ABCD2评分联合MRA检查对短暂性脑缺血发作后发生脑梗死的预测价值  

Value of ABCD2 Scoring Combined with MRA in Predicting Cerebral Infarction After Transient Ischemic Attack

作　　者：王丽[1] 戴海琳 唐旭[2] 杨月君[1] 孙坤钰 余兰 Wang Li;Dai Hailin;Tang Xu;Yang Yuejun;Sun Kunyu;Yu Lan(Department of Neurology, The Second Hospital of Baoding, Baoding 071000, China;Department of Ultrasound, The First Hospital of Baoding, Baoding 071000, China)

机构地区：[1]保定市第二医院神经内科,保定071000 [2]保定市第一医院超声科,保定071000

出　　处：《成都医学院学报》2020年第5期595-598,共4页Journal of Chengdu Medical College

基　　金：保定市科技计划项目(No:1951ZF019)。

摘　　要：目的探究ABCD2评分联合磁共振血管造影(MRA)检查对短暂性脑缺血发作(TIA)后发生脑梗死的预测价值。方法纳入保定市第二医院神经内科2017年9月至2019年9月收治的108例TIA患者,所有患者均行ABCD2评分及MRA检查,TIA发病7 d内进行头颅MRI检查,统计脑梗死发生率。结果ABCD2评分低危组脑梗死发生率为4.69%(3/64),中危组为43.33%(13/30),高危组为64.29%(9/14),中危组和高危组高于低危组(P<0.001),中危组和高危组差异无统计学意义(P=0.195);颅内动脉正常或轻度狭窄组脑梗死发生率为10.87%(5/46),中度狭窄组为20.51%(8/39),重度狭窄组为56.52%(13/23),重度狭窄组高于正常或轻度狭窄组和中度狭窄组(P<0.001和P=0.004);狭窄≥50%且ABCD2评分≥4分患者,脑梗死发生率高于狭窄≥50%且ABCD2评分<4分患者,以及狭窄<50%且ABCD2评分≥4分患者(P<0.05);多因素Logistic回归分析结果显示,高血压(OR=8.998)、低密度脂蛋白(LDL)≥2.6 mmol/L(OR=15.656)、症状持续时间≥60 min(OR=11.145)均为TIA患者发生脑梗死的独立危险因素(P=0.045、0.023、0.002)。结论ABCD2评分法预测脑梗死风险准确性较高,进一步结合MRA检查能提高预测准确性。高血压、LDL、症状持续时间是影响TIA后脑梗死的危险因素。Objective To investigate the value of ABCD2 scoring combined with magnetic resonance angiography(MRA)in predicting the occurrence of cerebral infarction after transient ischemic attack(TIA).Methods A total of 108 TIA patients admitted into The Second Hospital of Baoding from September of 2017 to September of 2019 were included in the study.All those patients underwent the ABCD2 scoring and MRA examination.The head MRI examinations were performed within 7 days of the TIA onset to analyze the incidence of cerebral infarction.Results The incidences of cerebral infarction were 4.69%(3/64)in the low-risk group,43.33%(13/30)in the medial-risk group and 64.29%(9/14)in the high-risk group according to the ABCD2 scores,and those in the medial-risk and high-risk groups were significantly higher than that in the low-risk group(P<0.001).And there was no statistically significant difference in the ABCD2 scores between the medial-risk group and the high-risk group(P=0.195).In terms of intracranial arterial stenosis,the incidences of cerebral infarction were 10.87%(5/46)in the normal or mild group,20.51%(8/39)in the moderate group and 56.52%(13/23)in the severe group,and the incidence of cerebral infarction in the severe group was significantly higher than that in the normal or mild group(P<0.001)and that in the moderate group(P=0.004).The incidence of cerebral infarction in the patients with the stenosis≥50%and ABCD2 score≥4 was significantly higher than that in the patients with stenosis≥50%and ABCD2 score<4 and that in the patients with stenosis<50%and ABCD2 score≥4(P<0.05).The results of the multivariate logistic regression analysis showed that hypertension(OR=8.998,P=0.045),low-density lipoprotein(LDL)≥2.6 mmol/L(OR=15.656,P=0.023)and symptom duration≥60min(OR=11.145,P=0.002)were the independent risk factors for cerebral infarction in TIA patients.Conclusion The accuracy of ABCD2 scoring is relatively high in predicting the risk of cerebral infarction and it can be improved if combined with MRA.Hypertension,LDL

关 键 词：短暂性脑缺血发作 脑梗死 磁共振血管造影 ABCD2评分法 诊断价值 

分 类 号：R743.32[医药卫生—神经病学与精神病学]