CAJ | 학술논문

目的：探讨联合评分方法对短暂性脑缺血发作（transient is chemic attack ，TIA）后早期卒中风险进行评估的效能。方法收集120例TIA患者，通过头DWI明确有无新鲜梗死。入院后对患者进行ABCD2评分，检测患者血清超敏C反应蛋白（hypersensitive C-reactive protein ，hs-CRP）、血浆纤维蛋白原（fibrinogen ，FIB）的含量。在ABCD2评分基础上，结合血清hs-CRP、FIB结果形成联合评分，对比分析 TIA后1周内ABCD2评分与联合评分两种方法的评估效能。结果120例T IA患者中，39例（32.5％）在发病1周内发生脑梗死。ABCD2评分与联合评分两种方法结果一致，脑梗死发病率由高到低顺序为：高危＞中危＞低危。联合评分低、中危组人数减少，高危组人数增加。与ABCD2评分比较，联合评分低、中危组脑梗死发病率降低，高危组脑梗死发病率升高。联合评分的ROC曲线下面积显著大于ABCD2评分（P＜0.001）。结论结合临床生化检验结果的联合评分效能高于单纯的ABCD2评分，联合评分能更好预测高危人群T IA后早期进展为脑梗死的风险，可用于临床指导T IA危险分层和治疗。
목적：탐토연합평분방법대단잠성뇌결혈발작（transient is chemic attack ，TIA）후조기졸중풍험진행평고적효능。방법수집120례TIA환자，통과두DWI명학유무신선경사。입원후대환자진행ABCD2평분，검측환자혈청초민C반응단백（hypersensitive C-reactive protein ，hs-CRP）、혈장섬유단백원（fibrinogen ，FIB）적함량。재ABCD2평분기출상，결합혈청hs-CRP、FIB결과형성연합평분，대비분석 TIA후1주내ABCD2평분여연합평분량충방법적평고효능。결과120례T IA환자중，39례（32.5％）재발병1주내발생뇌경사。ABCD2평분여연합평분량충방법결과일치，뇌경사발병솔유고도저순서위：고위＞중위＞저위。연합평분저、중위조인수감소，고위조인수증가。여ABCD2평분비교，연합평분저、중위조뇌경사발병솔강저，고위조뇌경사발병솔승고。연합평분적ROC곡선하면적현저대우ABCD2평분（P＜0.001）。결론결합림상생화검험결과적연합평분효능고우단순적ABCD2평분，연합평분능경호예측고위인군T IA후조기진전위뇌경사적풍험，가용우림상지도T IA위험분층화치료。
Objective To investigate the application of composite scoring system in evaluating the early stroke risk after transient ischemic attack risk(TIA). Methods 120 patients with TIA were evaluated by the ABCD2 score ,and then the hyper-sensitive C-reactive protein (hs-CRP) and fibrinogen (FIB) in serum were measured. The ABCD2 score combined with the re-sults of hs-CRP and FIB formed the composite scoring system ,and then the area under the receiver operating characteristic (ROC) curve were compared between the ABCD2 score and the composite scoring system. Results The area under the ROC curve of composite scoring system was significantly larger than that of ABCD 2.Conclusion The composite scoring system cri-teria can effectively predict the early occurrence of cerebral infarction after TIA ,and guide the aggressive diagnostic protocols and therapy of T IA.