【摘要】：背景短暫性腦缺血發(fā)作（transient ischemic attack，TIA）是反復(fù)發(fā)作的、局灶性腦血管或視網(wǎng)膜動(dòng)脈缺血導(dǎo)致突發(fā)短暫性、可逆性神經(jīng)功能缺陷。TIA是一種臨床急癥，其近期發(fā)生腦卒中的風(fēng)險(xiǎn)很高，尤其發(fā)生在TIA后48小時(shí)內(nèi)。有研究表明，TIA后7d內(nèi)腦卒中發(fā)生率高達(dá)35%，且患者90d內(nèi)TIA復(fù)發(fā)、心肌梗死和死亡事件總的風(fēng)險(xiǎn)亦較高。因此，對(duì)TIA患者進(jìn)行評(píng)估和有效干預(yù)對(duì)防止腦卒中發(fā)生有著重要的意義。 目的探討并比較采用ABCD2-I與ABCD3-I評(píng)分系統(tǒng)預(yù)測(cè)短暫性腦缺血發(fā)作（TIA）患者近期發(fā)生腦卒中風(fēng)險(xiǎn)的臨床價(jià)值。 方法收集154例TIA住院患者的臨床和影像學(xué)資料。運(yùn)用ABCD2、ABCD3、ABCD2-I、ABCD3-I評(píng)分法進(jìn)行評(píng)分，采用曲線下面積（AUC）值評(píng)估并比較ABCD2-I與ABCD3-I評(píng)分系統(tǒng)預(yù)測(cè)TIA后腦卒中風(fēng)險(xiǎn)的價(jià)值。 結(jié)果154例TIA患者于7d內(nèi)進(jìn)展為腦卒中12例（7.8%），90d內(nèi)19例（12.3%）。將ABCD3-I評(píng)分分為低危組（0-3分）、中危組（4-7分）、高危組（8-13分）。分別與低危組、中危組比較，高危組TIA后7和90d腦卒中發(fā)生率均明顯增高，差異有顯著統(tǒng)計(jì)學(xué)意義（P均0.01）。預(yù)測(cè)TIA后7d內(nèi)腦卒中風(fēng)險(xiǎn)時(shí)，ABCD2、ABCD2-I、ABCD3、ABCD3-I評(píng)分AUC分別為0.733、0.898、0.830和0.935；預(yù)測(cè)TIA后90d內(nèi)卒中風(fēng)險(xiǎn)時(shí)，分別為0.699、0.857、0.778和0.906。 結(jié)論 ABCD3-I評(píng)分法預(yù)測(cè)TIA后腦卒中發(fā)生率時(shí)，其準(zhǔn)確性優(yōu)于ABCD2-I評(píng)分法，，具有更高的臨床應(yīng)用價(jià)值。
[Abstract]:Background transient ischemic attack (transient ischemic attack,TIA) is a recurrent attack. Focal cerebral vascular or retinal artery ischemia leads to sudden transient and reversible neurological dysfunction. TIA is a clinical emergency. The risk of recent stroke is high, especially within 48 hours of TIA. Studies have shown that the incidence of stroke is as high as 35% within 7 days after TIA, and the total risk of myocardial infarction and death events is also higher in patients with recurrent TIA within 90 days. Therefore, the evaluation and effective intervention of TIA patients have important significance in preventing stroke. Objective to explore and compare the clinical value of ABCD2-I and ABCD3-I scoring system in predicting the risk of stroke in patients with transient ischemic attack (TIA). Methods the clinical and imaging data of 154 inpatients with TIA were collected. The ABCD2,ABCD3,ABCD2-I,ABCD3-I scoring method was used to evaluate the area under curve (AUC) value and to compare the value of ABCD2-I and ABCD3-I scoring system in predicting the risk of stroke after TIA. Results 12 (7.8%) of the 154 patients with TIA developed stroke within 7 days and 19 (12.3%) within 90 days. ABCD3-I score was divided into low risk group (0-3 points), middle risk group (4-7 points) and high risk group (8-13 points). Compared with low risk group and middle risk group, the incidence of cerebral apoplexy in high risk group was significantly higher than that in low risk group and middle risk group at 7 and 90 days after TIA (P 0.01). In predicting stroke risk within 7 days after TIA, the AUC score of ABCD2,ABCD2-I,ABCD3,ABCD3-I was 0.733-0.8980.0.830 and 0.935 respectively, and that of stroke within 90 days after TIA was 0.6990.8570.778 and 0.906, respectively. Conclusion the accuracy of ABCD3-I scoring method in predicting the incidence of stroke after TIA is better than that of ABCD2-I scoring method, and it has higher clinical application value.
【學(xué)位授予單位】：蘇州大學(xué)
【學(xué)位級(jí)別】：碩士
【學(xué)位授予年份】：2014
【分類號(hào)】：R743.3

【參考文獻(xiàn)】

相關(guān)期刊論文 前2條

1 朱英標(biāo);盧麗萍;;ABCD2評(píng)分結(jié)合頭頸CTA對(duì)短暫性腦缺血發(fā)作后近期發(fā)生腦梗死的評(píng)估價(jià)值[J];中國(guó)臨床神經(jīng)科學(xué);2011年06期

2 張曉丹;秦偉;胡文立;;ABCD~3-Ⅰ評(píng)分預(yù)測(cè)短暫性腦缺血發(fā)作后早期卒中風(fēng)險(xiǎn)[J];中國(guó)卒中雜志;2012年01期

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