短暂性脑缺血发作后脑梗死风险预测模型ABCD2评分法的价值验证与改良-神经病学专业论文.docxVIP

评分为 5 分的患者 40 例，进展为脑梗死 10 例，脑梗死的发生率 25%；评分为 6 分的患者 28 例，进展为脑梗死 15 例，脑梗死的发生率 54%；评分≥7 分的患者 12 例,进展为脑梗死 7 例，脑梗死的发生率为 58%。低危( 0-3 分)、中危( 4 -5 分) 和高危( 6 -8 分)组 7d 内发生脑梗死的比例分别为 4%、21%和 55%(P 0.05)。症状 持续超过 10 min、运动障碍、糖尿病、高血压病，入院时血压≥140/90 mmHg 和 Fib≥3.5g/L 均是 TIA 后 7d 内发生脑梗死的危险因素。 结论 ABCD2 评分法在判断 TIA 后早期脑梗死风险方面有一定的预测价值，但 ABCD2 F 具有更高的临床价值，可更好地帮助医生鉴别高危患者，以便采取最佳 的卒中预防措施。 关键词 短暂性脑缺血发作 脑梗死 ABCD2 F(ABCD2+Fib)评分法 ABCD2 评分法 预测 Validation and Refinement of the ABCD2 Score to Predict Cerebral Infarction Risk after Transient Ischemic Attack Abstract Objective To validate the ABCD2 score and explore the ability of ABCD2F(ABCD2+Fib) score in predicting cerebral infarction of transient ischemic attack (TIA) patients at 7th day. Methods The age , sex, blood pressure , clinical features , diabetes ,hypertension and fibrinogen were collected in a cohort of hospitalized 135 TIA patients. The California,ABCD,ABCD2 and ABCD2 F scores were applied to all the patients and used to observe the 7-day cerebral infarction risk. We analysised the relationship between clinical data and cerebral infarction risk. A 8-point scoring system was described for stratifying risk after TIA. This score incorporates age(A)，blood Pressure(B)，clinical features(C)，duration (D), diabetes (D) and fibrinogen(F)of TIA patiens(age ≥60years [1 point]; blood pressure≥140/90 mmHg [1]; clinical features: unilateral weakness [2], speech impairment without weakness[1]; duration ≥60 minutes [2] or 10 to 59 minutes [1]; diabetes [1] and fibrinogen≥3.5g/L [1]). The TIA patients were classified as high risk (score 6 to 8), moderate risk (score 4 to5), and low risk (score 0 to 3). Results The AUCs(95%CI) of the ABCD2 F, ABCD2, ABCD and California scores are 0.755(0.668-0.842),0.711(0.618-0.804),0.658(0.562-0.754), 0.534(0.428-0.639) respective.13 TIA patients scored 2 or less ,and the occurrence of cerebral infarction is 0 ; 12 patients scored 3, and the occurrence is 8%; 30 patients scored 4, and the occurrence is 17%;