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    ABCD评分系统在短暂性脑缺血发作病人早期发生脑卒中风险的预测

    Value of ABCD score in predicting early risk of cerebral ischemic stroke after transient ischemic attack

      摘要
    • 摘要:
      目的进一步明确基于中国人群的短暂性脑缺血发作（transient ischemic attack，TIA）病人，3种ABCD评分系统预测TIA发作后7 d内发生新发脑梗死风险的临床应用价值。
      方法150例TIA病人于入院48 h内采用ABCD2、ABCD3、ABCD3-Ⅰ3种评分系统，根据评分分为低危、中危及高危组；根据病人TIA发作后7 d内是否继发脑梗死分为新发脑梗死组和非脑梗死组，比较2组TIA病人的3种评分系统评分；记录3种评分的低、中、高危组中TIA后7 d内继发脑梗死病人例数。
      结果与非脑梗死组比较，新发脑梗死组的3种不同的ABCD系统的评分结果均升高，差异具有统计学意义（P < 0.05~P < 0.01）；除ABCD2评分外，随着ABCD3、ABCD3-Ⅰ评分分值的升高，7 d内继发脑梗死率不断增加（P < 0.01）；ROC曲线分析发现，3种ABCD评分系统对7 d内继发脑梗死的预测AUC分别为0.67、0.84和0.91，均大于基准线面积的0.5，差异有统计学意义（P < 0.01）。ABCD3-Ⅰ预测7 d内继发脑梗死准确度优于ABCD3，ABCD3优于ABCD2，差异具有统计学意义（P < 0.01）。
      结论3种ABCD评分方法均能预测TIA后7 d内继发的新发脑梗死，分值越高，7 d内继发新发脑梗死的危险度越高，ABCD3-Ⅰ预测准确度最高。

       

      Abstract:
      ObjectiveTo investigate the clinical value of three kinds of ABCD score in predicting the risk of new cerebral ischemic stroke within 7 days after transient ischemic attack(TIA)in Chinese.
      MethodsThe scores in 150 patients with TIA were evaluated using ABCD2, ABCD3 and ABCD3-Ⅰ score within 48 h of admission, and the patients were divided into the low, medium and high risk groups according to the score.According to the onset of new ischemic stroke within 7 days after TIA, 150 patients were divided into the new ischemic stroke group(50 patients) and non-new ischemic stroke(100 patients).Three kinds of scores between two groups were compared.The number of patients with secondary cerebral infarction in the low, medium and high risk groups within 7 days after TIA was recorded.
      ResultsCompared with the non-new ischemic stroke group, the scores of three kinds of ABCD score significantly increased in new ischemic stroke group, and the difference of which was statistically significant(P < 0.05 to P < 0.01).Except the score of ABCD2, with the increasing of the scores of ABCD3 and ABCD3-Ⅰ, the incidence rate of secondary cerebral infarction increased continuously within 7 days after TIA(P < 0.01).The area under the ROC curve showed that the predictive AUC value of three kinds of ABCD score was 0.67, 0.84 and 0.91 within 7 days after TIA, respectively, and the differences of those were statistically significant(P < 0.01).The degrees of accuracy of ABCD3-Ⅰ and ABCD3 score in predicting the secondary cerebral infarction within 7 days after TIA were better than those of ABCD3 and ABCD2 score, respectively(P < 0.01).
      ConclusionsABCD2, ABCD3 and ABCD3-Ⅰ score can predict the secondary cerebral infarction within 7 days after TIA, and the higher the score, the higher the secondary cerebral infarction risk within 7 days after TIA is.The prediction accuracy of ABCD3-Ⅰ score is the highest.

       

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