中国脑血管病杂志
中國腦血管病雜誌
중국뇌혈관병잡지
CHINESE JOURNAL OF CEREBROVASCULAR DISEASES
2014年
12期
634-638
,共5页
路文革%张建平%代允义%赵明
路文革%張建平%代允義%趙明
로문혁%장건평%대윤의%조명
短暂性脑缺血发作%卒中%危险因素%ABCD3-I%ABCD2
短暫性腦缺血髮作%卒中%危險因素%ABCD3-I%ABCD2
단잠성뇌결혈발작%졸중%위험인소%ABCD3-I%ABCD2
Transient ischemic attack%Stroke%Risk factors%ABCD3-I%ABCD2
目的:评价ABCD3-I评分法对短暂性脑缺血发作(TIA)后早期卒中风险的预测价值。方法连续纳入2010年1月—2012年12月入住商丘市第一人民医院神经内科的TIA患者136例,收集患者的一般临床资料、病史及影像学检查结果,观察90 d内卒中发生率,对TIA后发生卒中风险进行ABCD2、ABCD3-I评分。采用Logistic回归分析方法分析影响TIA后早期卒中发生的危险因素,采用受试者工作特性曲线下面积(AUC)比较两种评分的预测价值。结果在纳入的136例TIA患者中,TIA后90 d内发生脑梗死19例(14.0%),无死亡及出血性卒中。多因素回归分析结果显示:TIA发作持续时间≥60 min(OR=1.060,95%CI:1.012~1.112)是TIA后早期进展为卒中的独立危险因素(P<0.05)。ABCD2评分模型危险分层低、中、高危组90 d内卒中发生率分别为5.6%(4/72)、18.5%(10/54)、50.0%(5/10),ABCD3-I评分模型危险分层低、中、高危组90 d内卒中发生率分别为0、7.1%(6/84)、52.0%(13/25),ABCD3-I与ABCD2评分模型危险分层低、中、高危组90 d卒中发生率差异有统计学意义(P<0.01)。ABCD3-I评分 AUC为0.839(95%CI:0.766~0.896),明显高于ABCD2 AUC的0.783(95%CI:0.704~0.849;P<0.01)。结论 ABCD3-I评分法能有效预测TIA后早期卒中风险,其准确性优于ABCD2评分。
目的:評價ABCD3-I評分法對短暫性腦缺血髮作(TIA)後早期卒中風險的預測價值。方法連續納入2010年1月—2012年12月入住商丘市第一人民醫院神經內科的TIA患者136例,收集患者的一般臨床資料、病史及影像學檢查結果,觀察90 d內卒中髮生率,對TIA後髮生卒中風險進行ABCD2、ABCD3-I評分。採用Logistic迴歸分析方法分析影響TIA後早期卒中髮生的危險因素,採用受試者工作特性麯線下麵積(AUC)比較兩種評分的預測價值。結果在納入的136例TIA患者中,TIA後90 d內髮生腦梗死19例(14.0%),無死亡及齣血性卒中。多因素迴歸分析結果顯示:TIA髮作持續時間≥60 min(OR=1.060,95%CI:1.012~1.112)是TIA後早期進展為卒中的獨立危險因素(P<0.05)。ABCD2評分模型危險分層低、中、高危組90 d內卒中髮生率分彆為5.6%(4/72)、18.5%(10/54)、50.0%(5/10),ABCD3-I評分模型危險分層低、中、高危組90 d內卒中髮生率分彆為0、7.1%(6/84)、52.0%(13/25),ABCD3-I與ABCD2評分模型危險分層低、中、高危組90 d卒中髮生率差異有統計學意義(P<0.01)。ABCD3-I評分 AUC為0.839(95%CI:0.766~0.896),明顯高于ABCD2 AUC的0.783(95%CI:0.704~0.849;P<0.01)。結論 ABCD3-I評分法能有效預測TIA後早期卒中風險,其準確性優于ABCD2評分。
목적:평개ABCD3-I평분법대단잠성뇌결혈발작(TIA)후조기졸중풍험적예측개치。방법련속납입2010년1월—2012년12월입주상구시제일인민의원신경내과적TIA환자136례,수집환자적일반림상자료、병사급영상학검사결과,관찰90 d내졸중발생솔,대TIA후발생졸중풍험진행ABCD2、ABCD3-I평분。채용Logistic회귀분석방법분석영향TIA후조기졸중발생적위험인소,채용수시자공작특성곡선하면적(AUC)비교량충평분적예측개치。결과재납입적136례TIA환자중,TIA후90 d내발생뇌경사19례(14.0%),무사망급출혈성졸중。다인소회귀분석결과현시:TIA발작지속시간≥60 min(OR=1.060,95%CI:1.012~1.112)시TIA후조기진전위졸중적독립위험인소(P<0.05)。ABCD2평분모형위험분층저、중、고위조90 d내졸중발생솔분별위5.6%(4/72)、18.5%(10/54)、50.0%(5/10),ABCD3-I평분모형위험분층저、중、고위조90 d내졸중발생솔분별위0、7.1%(6/84)、52.0%(13/25),ABCD3-I여ABCD2평분모형위험분층저、중、고위조90 d졸중발생솔차이유통계학의의(P<0.01)。ABCD3-I평분 AUC위0.839(95%CI:0.766~0.896),명현고우ABCD2 AUC적0.783(95%CI:0.704~0.849;P<0.01)。결론 ABCD3-I평분법능유효예측TIA후조기졸중풍험,기준학성우우ABCD2평분。
Objective To evaluate the predictive value of ABCD3-I score for early stroke risk after transient ischemic attack (TIA). Methods A total of 136 consecutive patients with TIA admitted to the Department of Neurology,the First Hospital of Shangqiu from January 2010 to December 2012 were enrolled. The clinical data,medical history and image findings of the patients were collected. The incidence of stroke was observed within 90 days. The occurrence of stroke risk after TIA were scored with the ABCD2 and ABCD3-I. Logistic regression analysis was used to analyze the impact of risk factors for early stroke after TIA. The area under the curve (AUC)of receiver operating characteristic was used to compare the predictive values of the two kinds of scores. Results Of the 136 eligible patients with TIA,19 cases (14. 0%)had cerebral infarction within 90 days after TIA. There were no death and hemorrhagic stroke. The results of multivariate regression analysis showed that the duration of TIA≥60 min (OR,1. 060,95%CI 1. 012-1. 112)was an independent risk factor for early progressing stroke after TIA (P<0. 05). In the ABCD2 scoring model for risk stratification of low-,moderate-,high-risk groups,the incidences of stroke within 90 days were 5. 6%(4/72),18. 5%(10/54),and 50. 0%(5/10),respectively. In the ABCD3-I score model for risk stratification of low-,moderate-,high-risk groups,the incidences of stroke within 90 days were 0,7. 1%(6/84),and 52. 0%(13/25),respectively. In the low-,moderate-,high-risk groups,there were significant differences in the incidences of stroke in 90 days between the ABCD3-I and ABCD2 scoring models (P<0.01). The AUC of ABCD3-I score (0. 839,95%CI 0. 766-0. 896)was higher than that of ABCD2 score (0.783,95%CI 0. 704-0. 849;P<0. 01). Conclusion The ABCD3-I score may effectively predict the risk of early stroke after TIA,and its accuracy is better than ABCD2 score.