【摘要】 目的评价ABCD~2评分预测TIA患者进展为脑梗死的应用,同时评估联合同型半胱氨酸血症(Hcy)对TIA患者脑梗死发生率的影响。方法测定198例TIA患者的ABCD~2评分值、同型半胱氨酸值、进展脑梗死的发生率。分析不同评分的TIA患者的脑梗死率差别,并分析高Hcy对TIA患者脑梗死发生率的影响。应用ROC曲线分析计算曲线下面积(AUC)评价ABCD2评分及其与Hcy结合预测TIA进展脑梗死的价值。结果 (1)评分≤3分的TIA患者有37例,发生脑梗死者3例(8%);(2)评分4或5分的患者总共105例,发生脑梗死者22例(21%);(3)评分≥6分的患者总共56例,脑梗死者22例(39%)。TIA患者的不同ABCD~2评分值的脑梗死发生率的差异均有统计学意义(P<0.05)。高Hcy为脑梗死的危险因素,两组TIA患者的脑梗死发生率的差别有统计学意义(P<0.05)。ABCD~2联合Hcy评分法和ABCD2评分法的曲线下面积(AUC)分别为0.815(0.679~0.899)和0.764(0.625~0.863)。结论 TIA患者不同的ABCD~2评分值脑梗死的发生率不同,分值越高,发生率越高,高Hcy为TIA进展脑梗死的危险因素。ABCD~2联合Hcy评分标准是临床上预测TIA短期进展为脑梗死的一种比较有效的方法。更多还原

【Abstract】 Objective Evaluating the ABCD~2 scoring method for the prediction of the progress of TIA to the cerebral infarction in hospitalized patients and the effects of hyperhomocysteinemia(Hcy) on the incidence rate of cerebral infraction in TIA patients. Methods The ABCD~2 score, basic clinical features, and incidence rate of cerebral infarction were measured for 198 hospitalized TIA patients. The difference of cerebral infarction rates between TIA patients with different scores and to analyze the effect of Hcy on the incidence rate of cerebral infarction in TIA patients were analysed. The area under the curve(AUC) was calculated by ROC curve to evaluate the ABCD~2 scoring and its combination with Hcy to predict the progress of cerebral infarction in TIA patients. Results(1)37 TIA patients with score ≤ 3, 3 cerebral infarction(8%).(2)105 TIA patients with score=4 or 5, 22 cerebral infarction(8%).(3)56 TIA patients with score ≥ 6, 22 cerebral infarction(39%). The variation of the incidence rates of cerebral infarction of TIA patients with different ABCD~2 scores is statistically significant(P < 0.05). Hcy is the risk factor of cerebral infarction and the variation of incidence rate of cerebral infarction in the two groups of TIA patients is statistically significant(P < 0.05). The scoring method of the combination of ABCD~2 and Hcy and the area under the curve(AUC) by ABCD~2 scoringare respectively 0.815(0.679 ~ 0.899) and 0.764(0.625 ~ 0.863). Conclusion The incidence rates of cerebral infarction in TIA patients with different ABCD2 scores are different. The higher the score, the higher the incidence rate. The combination of ABCD2 scoring with Hcy is an effective method for predicting the short-term cerebral infarction progress of TIA patients.更多还原