【摘要】：目的：評估ABCD2責任血管狹窄評分對短暫性腦缺血發(fā)作（transient ischemicattack，TIA）患者7天內(nèi)發(fā)生腦梗死的預測價值，比較ABCD2評分與ABCD2責任血管狹窄評分的有效性。 方法：以2012年3月至2013年12月由皖南醫(yī)學院附屬弋磯山醫(yī)院神經(jīng)內(nèi)科收住院的67例TIA患者為研究對象，收集其臨床病史資料及影像學檢查結果，隨訪觀察7天內(nèi)腦梗死發(fā)生人數(shù)。按照ABCD2評分進行評分并分為低危（0~3分）、中危（4~5分）、高危（6~7分）三組，比較各組之間7天內(nèi)腦梗死發(fā)生率。所有病例依據(jù)臨床特征確定責任血管，在住院期間行磁共振血管造影術（magneticresonance angiography，MRA）測量責任血管狹窄程度。根據(jù)責任血管狹窄程度將病例分為≥50%組和＜50%組，比較兩組腦梗死發(fā)生率。依照不同ABCD2評分分組、不同責任血管狹窄程度再次進行分組，比較各組的腦梗死發(fā)生率。在ABCD2評分中，加入責任血管狹窄程度（2分）這一影響因素，形成ABCD2責任血管狹窄評分，并分為低危（0~3分）、中危（4~6分）、高危（7~9分）三組，比較各組之間腦梗死發(fā)生率。通過繪制ROC曲線，，評估ABCD2評分及ABCD2責任血管狹窄評分對TIA發(fā)作后7天內(nèi)腦梗死發(fā)生風險的預測價值。 結果：67例TIA患者中，18例在7天內(nèi)發(fā)生腦梗死。按照ABCD2評分分組，低危組30例，3例發(fā)生腦梗死；中危組31例，11例發(fā)生腦梗死；高危組6例，4例發(fā)生腦梗死，差異具有統(tǒng)計學意義（P0.05）。責任血管狹窄≥50%組27例TIA患者，12例發(fā)生腦梗死；50%組40例，6例發(fā)生腦梗死，兩組之間具有統(tǒng)計學差異（P0.05）.按照ABCD2責任血管狹窄評分分組，低、中、高組的腦梗死發(fā)生率分別為10.7%、28.1%、85.7%，差異有統(tǒng)計學意義（P0.05）.繪制ROC曲線，ABCD2責任血管狹窄評分曲線下面積0.763（0.663~0.863）高于ABCD2評分曲線下面積0.680(0.570~0.790)。 結論：1.ABCD2評分高危組、中危組腦梗死發(fā)生率與低危組比較具有顯著統(tǒng)計學差異；ABCD2評分越高，TIA后早期腦梗死發(fā)生率也越高。 2.責任血管狹窄≥50%是TIA后發(fā)生腦梗死的危險因素； ABCD2責任血管狹窄評分與TIA后腦梗死發(fā)生率具有正相關關系，評分越高，腦梗死發(fā)生率越高。 3.ABCD2責任血管狹窄評分各危險組之間腦梗死發(fā)生率具有顯著差異，可以用ABCD2責任血管狹窄評分來評估TIA患者的卒中風險。 4.ABCD2責任血管狹窄評分ROC曲線下面積大于ABCD2評分ROC曲線下面積，且具有統(tǒng)計學差異，提示，ABCD2責任血管狹窄評分有效性較高，更具有臨床實用價值。
[Abstract]:Objective: to evaluate the predictive value of ABCD2 responsible vascular stenosis score for cerebral infarction in patients with transient ischemic attack (transient) within 7 days, and to compare the effectiveness of ABCD2 score and ABCD2 responsible vascular stenosis score. Methods: from March 2012 to December 2013, 67 patients with TIA were collected from the Department of Neurology, affiliated to the Southern Anhui Medical College, and their clinical history and imaging findings were collected. Patients with cerebral infarction were followed up for 7 days. According to ABCD2 score, the patients were divided into three groups: low risk (0 ~ 3), moderate risk (4 ~ 5) and high risk (6 ~ 7). The incidence of cerebral infarction within 7 days was compared among the three groups. In all cases, the responsible vessels were determined according to the clinical features, and the degree of stenosis was measured by magneticresonance angiography. According to the degree of stenosis of responsible vessels, the patients were divided into 鈮

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