ABCD^(2)评分联合T_(2) Flair高信号血管征对TIA患者不同时期预后的预测作用  

Predictive effect of ABCD^(2) score combined with T_(2) Flair hyperintensity vascular sign on the prognosis of patients with TIA at different stages

作　　者：柯国秀[1] 王国军[1] 季立标[1] 张军[1] 严俊[1] 朱银伟 KE Guo-xiu;WANG Guo-jun;JI Li-biao(Department of Neurology,the NO.1 People Hospital of Changshu,Changshu 215500,China)

机构地区：[1]江苏省常熟市第一人民医院神经内科,215500

出　　处：《临床神经病学杂志》2021年第5期363-367,共5页Journal of Clinical Neurology

基　　金：2018年度常熟市科技局资助项目(CS201810)。

摘　　要：目的探讨ABCD2评分联合3.0 T MRI的Flair的高信号血管征(HVS)对TIA患者不同时期预后的预测作用。方法选取我科2018年4月至2019年7月符合入选标准的TIA患者,记录基线资料及相关辅助检查结果,进行ABCD2评分。所有患者均行常规头颅MRI、Flair检查,计算TIA患者的Flair HVS阳性率和ABCD2评分结果。观察7 d内、90 d内及1年内TIA的预后,以再发脑血管事件为终点,评估ABCD2评分分组及HVS与ABCD2结合分层预测脑血管事件的作用。结果与HVS阴性组相比,HVS阳性组高血压史、糖化血红蛋白水平、低密度脂蛋白水平、卒中家族史、既往卒中史、ABCD2评分、ABCD2中高危比例显著升高,差异有统计学意义(均P<0.05)。应用ROC曲线分析,预测脑血管病发生风险时,ABCD2评分分组的7 d内、90 d内、1年内的曲线下面积(AUC)值分别为0.783、0.645、0.641;二者结合的7 d内、90 d内、1年内的AUC值分别为0.902、0.739、0.786。结论 ABCD2评分对TIA患者短期卒中风险的预测价值更高,结合HVS阳性结果可以进一步提高预测TIA不同时期预后的准确性。Objective To investigate the predictive effect of ABCD2 score combined with high signal vascularity(HVS) of 3.0 T MRI Flair sequence on the prognosis of patients with TIA. Methods Patients with TIA who met the inclusion criteria from April 2018 to July 2019 in our department were selected. The baseline data and related auxiliary examination results were recorded, and ABCD2 score was performed. All patients underwent routine head MRI and Flair examination. The positive rate of flair HVS and ABCD2 score were calculated. The prognoses of TIA within 7 d, 90 d and 1 year were observed, and the role of ABCD2 score grouping and HVS combined with ABCD2 stratification in predicting cerebrovascular events were evaluated with recurrent cerebrovascular events as the end point. Results Compared with the HVS negative group, the history of hypertension, glycosylated hemoglobin level, low density lipoprotein level, family history of stroke, history of previous stroke, ABCD2 score and the proportion of high risk in ABCD2 in the HVS positive group were significantly higher(all P<0.05). When ROC curve analysis was used to predict the risk of cerebrovascular disease, the area under curve(AUC) values within 7 d, 90 d and 1 year of ABCD2 score group were 0.783, 0.645 and 0.641 respectively;the combined AUC values within 7 d, 90 d and 1 year were 0.902, 0.739 and 0.786 respectively. Conclusions ABCD2 score has higher predictive value for short-term stroke risk in patients with TIA. Combined with HVS positive results, it can further improve the accuracy of predicting prognosis in different stages of TIA.

关 键 词：TIA 高信号血管征 ABCD^(2)评分 预后 

分 类 号：R743.3[医药卫生—神经病学与精神病学]