加拿大TIA评分预测TIA后缺血性脑卒中风险的价值及其与ABCD2评分的诊断效能比较  

Value of Canadian TIA score in predicting the risk of ischemic stroke after TIA and its comparison with the diagnostic efficacy of ABCD2 score

作　　者：张文超[1] 尹涛 杨雪辉[1] 王睿健 张盟盟 张明哲[1] ZHANG Wenchao;YIN Tao;YANG Xuehui;WANG Ruijian;ZHANG Mengmeng;ZHANG Mingzhe(Department of Neurosurgery,People′s Hospital of Hengshui/International Peace Hospital,Harrison,Hengshui 053000,Hebei,China)

机构地区：[1]衡水市人民医院(哈励逊国际和平医院)神经外科,衡水053000

出　　处：《医学研究与战创伤救治》2023年第11期1149-1153,共5页Journal of Medical Research & Combat Trauma Care

基　　金：河北省科技计划重点研发项目(182777223);衡水市科技计划项目(202201483Z)。

摘　　要：目的 探究加拿大TIA评分预测短暂性脑缺血发作(TIA)发作7 d后发生缺血性脑卒中风险的效能,并与ABCD2评分进行对比。方法 回顾性选取2020年5月至2022年5月在衡水市人民医院急诊收治并确诊的174例TIA患者作为研究对象。以7 d内发生缺血性脑卒中为观察终点。以7 d内发生了缺血性脑卒中为阳性组,7 d内没有发生缺血性脑卒中为阴性组。分别采用加拿大TIA评分和ABCD2评分进行危险分层(加拿大TIA评分,低危:-3~3分,中危:4~8分,高危:9~23分;ABCD2评分,低危:0~3分,中危:4~5分,高危:6~7分),并进行比较。结果 7 d内发生缺血性脑卒中28例(16.1%)。在加拿大TIA评分中,低危27例,中危123例,高危24例,7 d内缺血性脑梗死发生情况:低危1例,中危19例,高危8例,区间似然比分别为0.18、1.11和1.74。ABCD2评分中,低危0例,中危159例,高危15例,7 d内缺血性脑梗死发生情况:低危0例,中危23例,高危5例,区间似然比分别为0、0.87和3.26。加拿大TIA评分受试者曲线的曲线下面积高于ABCD2评分(0.73 vs 0.61,P=0.001)。结论 加拿大TIA评分可以更好预测TIA患者早期发生脑梗死的风险,对控制TIA患者7 d内发生缺血性脑梗死具有重要的临床价值。Objective To explore the effectiveness of the Canadian TIA score in predicting the risk of ischemic stroke 7 days after the onset of TIA,and compare it with the ABCD2 score.Methods 174 patients with TIA who were admitted and diagnosed in the Emergency Department ofPeople′s Hospital of Hengshui from May 2020 to May 2022 were retrospectively selected as the study ob-jects.The end point was ischemic stroke within 7 days.The positive group with ischemic stroke occurred within 7 days,and the nega-tive group with no ischemic stroke occurred within 7 days.Canadian TIA score and ABCD2 score were used for risk stratification re-spectively(Canadian TIA score,low risk:-3-3 points,medium risk:4-8 points,high risk:9-23 points;ABCD2 scores,low risk:0-3 points,medium risk:4-5 points,high risk:6-7 points),and compared.Results Ischemic stroke occurred in 28 cases risk.The occurrence of ischemic cerebral infarction within 7 days was as follows:1 case of low-risk,19 cases of medium-risk,and 8 cases of high-risk,with interval likelihood ratios of 0.18,1.11,and 1.74,respectively.In ABCD2 scores,there were 0 cases of low risk,159 cases of medium risk and 15 cases of high risk.The occurrence of is-chemic cerebral infarction within 7 days was as follows:0 case of low risk,23 cases of medium risk,and 5 cases of high risk,with interval likelihood ratios of 0,0.87 and 3.26,respectively.The area under the curve of the Canadian TIA score was higher than that of the ABCD2 score(0.73 vs 0.61,P=0.001).Conclusion The Cana-dian TIA score can better predict the risk of early cerebral infarction in TIA patients,and has important clinical value in controlling is-chemic cerebral infarction in TIA patients within 7 days.

关 键 词：加拿大TIA评分 ABCD2评分 短暂性脑缺血发作 缺血性脑梗死 

分 类 号：R743.3[医药卫生—神经病学与精神病学]