CAJ | 학술논문

目的： ABCD2评分用于预测短暂性脑缺血发作（ transient ischemic attack ， TIA）患者短期卒中风险已经过大量研究验证，并在临床中广泛使用；但对于ABCD2预测不同供血区TIA患者短期卒中风险的报道较少。本研究旨在分别探讨ABCD2评分对于前循环和后循环TIA患者短期卒中风险的预测价值。方法连续性纳入南京卒中注册系统中2011年9月至2012年12月明确诊断的TIA患者，按症状分为前循环和后循环TIA。收集患者各种危险因素并进行为期共90 d的随访。分别计算每位患者ABCD2评分，通过受试者工作特征曲线对预测90 d卒中风险的能力进行分析。结果研究共纳入204例患者，其中前循环TIA 143例、后循环TIA 61例。患者平均年龄（63．7±11．2）岁，其中女性59例（28．9％）。90 d发生的卒中前循环11．2％、后循环9．8％，组间比较差异无统计学意义（P＝0．776）。患者平均ABCD2评分前循环（3．7±1．5）分、后循环（2．5±1．3）分，组间比较差异有统计学意义（P＜0．001）。 ABCD2预测前循环卒中风险曲线下面积为0．711（95％CI：0．575～0．847，P＝0．006）；预测后循环卒中风险的曲线下面积为0．559（95％CI：0．298～0．820，P＝0．637）。结论 ABCD2评分对前循环TIA患者早期卒中风险具有较好的预测价值，而对于后循环TIA后卒中风险预测效能一般。
목적： ABCD2평분용우예측단잠성뇌결혈발작（ transient ischemic attack ， TIA）환자단기졸중풍험이경과대량연구험증，병재림상중엄범사용；단대우ABCD2예측불동공혈구TIA환자단기졸중풍험적보도교소。본연구지재분별탐토ABCD2평분대우전순배화후순배TIA환자단기졸중풍험적예측개치。방법련속성납입남경졸중주책계통중2011년9월지2012년12월명학진단적TIA환자，안증상분위전순배화후순배TIA。수집환자각충위험인소병진행위기공90 d적수방。분별계산매위환자ABCD2평분，통과수시자공작특정곡선대예측90 d졸중풍험적능력진행분석。결과연구공납입204례환자，기중전순배TIA 143례、후순배TIA 61례。환자평균년령（63．7±11．2）세，기중녀성59례（28．9％）。90 d발생적졸중전순배11．2％、후순배9．8％，조간비교차이무통계학의의（P＝0．776）。환자평균ABCD2평분전순배（3．7±1．5）분、후순배（2．5±1．3）분，조간비교차이유통계학의의（P＜0．001）。 ABCD2예측전순배졸중풍험곡선하면적위0．711（95％CI：0．575～0．847，P＝0．006）；예측후순배졸중풍험적곡선하면적위0．559（95％CI：0．298～0．820，P＝0．637）。결론 ABCD2평분대전순배TIA환자조기졸중풍험구유교호적예측개치，이대우후순배TIA후졸중풍험예측효능일반。
Objective Many studies have proved that the ABCD 2 score can be used to predict early stroke risk after transient ischemic attack ( TIA) , but few reports are seen on its predictive value for early stroke risk after TIA in different types of circulation . This article aimed to evaluate the ABCD 2 score in predicting early stroke risk following anterior or posterior circulation TIA . Methods Patients with definitely diagnosed TIA consecutively included in Nanjing Stroke Registration System from September 2011 to December 2012 were classified into anterior and posterior circulation TIAs .Various risk factors were collected and a 90-day follow-up was conduc-ted.The ABCD2 score was obtained from each patient and its predictive value assessed using the receiver operating characteristic curve. Results A total of 204 patients were analyzed in the study , including 59 (28.9%) females, 143 with anterior and 61 with posterior circulation TIA, aged 63.7 ±11.2 years.There were no statistically significant differences in the incidence rate of stroke within 90 days between the anterior and posterior circulation TIAs (11.2% vs 9.8%, P=0.776).The mean ABCD2 score was re-markably higher in the anterior than in the posterior circulation TIA (3.7 ±1.5 vs 2.5 ±1.3, P<0.001).The area under the curve (AUC) in predicting stroke risk was 0.711 for the former (95%CI:0.575-0.847, P=0.006) and 0.555 for the latter (0.298-0.820, P=0.637). Conclusion The ABCD2 score can predict early stroke risk in anterior but not in posterior circulation TIA .