中国医师进修杂志
中國醫師進脩雜誌
중국의사진수잡지
CHINESE JOURNAL OF POSTGRADUATES OF MEDICINE
2014年
34期
26-28
,共3页
脑缺血发作,短暂性%预后%ABCD3-Ⅰ评分
腦缺血髮作,短暫性%預後%ABCD3-Ⅰ評分
뇌결혈발작,단잠성%예후%ABCD3-Ⅰ평분
Ischemic attack,transient%Prognosis%ABCD3-Ⅰ score
目的 探讨ABCD3-Ⅰ评分在判断短暂性脑缺血发作(TIA)预后中的价值.方法 根据ABCD2、ABCD3、ABCD3-Ⅰ评分标准,对106例TIA患者进行评定,观察7,90 d内脑梗死的发生情况.按照脑梗死风险程度分级,ABCD3-Ⅰ评分0～3分为低危组(36例),4～7分为中危组(36例),8～13分为高危组(34例).结果 高危组7,90 d内脑梗死发生率明显高于低危组和中危组[7d内:23.5％(8/34)比2.8％(1/36)和5.6％(2/36),90 d内:38.2％(13/34)比2.8％(1/36)和11.1％(4/36)],差异有统计学意义(P＜0.01).ABCD3-Ⅰ评分中症状持续时间≥10 min、伴有糖尿病、双重TIA发作、同侧颈动脉狭窄≥50％、弥散加权成像出现高信号是TIA患者7,90 d内发生脑梗死的危险因素(P＜0.05).ABCD3-Ⅰ评分预测7,90 d内TIA患者脑梗死风险的受试者工作特征曲线下面积均大于ABCD2和ABCD3评分(0.914比0.614和0.877,0.869比0.633和0.773).结论 ABCD3-Ⅰ评分可更好地预测TIA患者早期脑梗死风险,帮助临床鉴别不同危险级别患者,以便采取最佳的措施分层治疗.
目的 探討ABCD3-Ⅰ評分在判斷短暫性腦缺血髮作(TIA)預後中的價值.方法 根據ABCD2、ABCD3、ABCD3-Ⅰ評分標準,對106例TIA患者進行評定,觀察7,90 d內腦梗死的髮生情況.按照腦梗死風險程度分級,ABCD3-Ⅰ評分0～3分為低危組(36例),4～7分為中危組(36例),8～13分為高危組(34例).結果 高危組7,90 d內腦梗死髮生率明顯高于低危組和中危組[7d內:23.5％(8/34)比2.8％(1/36)和5.6％(2/36),90 d內:38.2％(13/34)比2.8％(1/36)和11.1％(4/36)],差異有統計學意義(P＜0.01).ABCD3-Ⅰ評分中癥狀持續時間≥10 min、伴有糖尿病、雙重TIA髮作、同側頸動脈狹窄≥50％、瀰散加權成像齣現高信號是TIA患者7,90 d內髮生腦梗死的危險因素(P＜0.05).ABCD3-Ⅰ評分預測7,90 d內TIA患者腦梗死風險的受試者工作特徵麯線下麵積均大于ABCD2和ABCD3評分(0.914比0.614和0.877,0.869比0.633和0.773).結論 ABCD3-Ⅰ評分可更好地預測TIA患者早期腦梗死風險,幫助臨床鑒彆不同危險級彆患者,以便採取最佳的措施分層治療.
목적 탐토ABCD3-Ⅰ평분재판단단잠성뇌결혈발작(TIA)예후중적개치.방법 근거ABCD2、ABCD3、ABCD3-Ⅰ평분표준,대106례TIA환자진행평정,관찰7,90 d내뇌경사적발생정황.안조뇌경사풍험정도분급,ABCD3-Ⅰ평분0～3분위저위조(36례),4～7분위중위조(36례),8～13분위고위조(34례).결과 고위조7,90 d내뇌경사발생솔명현고우저위조화중위조[7d내:23.5％(8/34)비2.8％(1/36)화5.6％(2/36),90 d내:38.2％(13/34)비2.8％(1/36)화11.1％(4/36)],차이유통계학의의(P＜0.01).ABCD3-Ⅰ평분중증상지속시간≥10 min、반유당뇨병、쌍중TIA발작、동측경동맥협착≥50％、미산가권성상출현고신호시TIA환자7,90 d내발생뇌경사적위험인소(P＜0.05).ABCD3-Ⅰ평분예측7,90 d내TIA환자뇌경사풍험적수시자공작특정곡선하면적균대우ABCD2화ABCD3평분(0.914비0.614화0.877,0.869비0.633화0.773).결론 ABCD3-Ⅰ평분가경호지예측TIA환자조기뇌경사풍험,방조림상감별불동위험급별환자,이편채취최가적조시분층치료.
Objective To explore the value of ABCD3-Ⅰ score in predicting prognosis of transient ischemic attack (TIA).Methods A total of 106 TIA patients were evaluated according to ABCD2,ABCD3 and ABCD3-Ⅰ criteria.The occurrence of cerebral infarction within 7 d and 90 d was observed.The patients with ABCD3-Ⅰ 0-3 scores were as low risk group (36 cases),the patients with ABCD3-Ⅰ 4-7 scores were as moderate risk group (36 cases),the patients with ABCD3-Ⅰ 8-13 scores were as high risk group (34 cases).Results The occurrence of cerebral infarction within 7 d and 90 d in high risk group was lower than that in low risk group and moderate risk group [within 7 d:23.5％(8/34) vs.2.8％(1/36) and 5.6％ (2/36),within 90 d:38.2％ (13/34) vs.2.8％ (1/36) and 11.1％ (4/36)],and there was significant difference (P ＜0.01).Symptom duration time ≥10 min in ABCD3-Ⅰ score,concomitant diabetes,double TIA,ipsilateral carotid artery stenosis ≥50％,high sign in diffusion weighted imaging were the risk factors for the occurrence of cerebral infarction within 7 d and 90 d in TIA patients (P ＜ 0.05).The area under the receiveroperating characteristic curve for predicting the occurrence of cerebral infarction within 7 d and 90 d in TIA patients by ABCD3-Ⅰ score was higher than that by ABCD2 and ABCD3 score (0.914 vs.0.614 and 0.877,0.869 vs.0.633 and 0.773).Conclusion The ABCD3-Ⅰ score is a simple and effective way to judge the short-term prognosis of TIA and can help to identify the different risk levels,so it is helpful in stratification treatment.
