Yuan Junliang, Jia Zejin, Song Yangguang, Hu Wenli
Department of Neurology, Beijing Chaoyang Hospital, Capital Medical University, Beijing, China.
Department of Pathology, Beijing Chaoyang Hospital, Capital Medical University, Beijing, China.
Front Neurol. 2019 Aug 13;10:796. doi: 10.3389/fneur.2019.00796. eCollection 2019.
Recently, the [diagnosis of transient ischemic attack (TIA), DOT] score has been recognized to be a new tool for non-specialists to diagnose TIA more accurately with the sensitivity and specificity being 89 and 76%, respectively. However, the DOT score has not yet been validated externally in patients with TIA in China. We retrospectively enrolled 500 consecutive patients with transient neurological symptoms, who were admitted to the Department of Neurology, Beijing Chaoyang Hospital and underwent magnetic resonance imaging (MRI) between Jan 2016 and Dec 2018. Patients with transient neurological symptoms were divided into two subgroups: TIA mimic group ( = 140, 28%) and definite cerebrovascular events group including tissue-based TIA (DWI negative, = 252, 50.4%) and minor stroke (DWI positive, = 108, 21.6%). The demographic data, clinical characteristics, laboratory findings, and scores of Dawson and DOT were compared between the two groups. A total of 500 patients with transient neurological symptoms (mean age, 61.1 ± 12.8) were enrolled and 70% ( = 350) were male. Comparing with TIA mimic groups, patients with cerebrovascular events group were more likely to have higher diastolic blood pressure, uric acid and homocysteine, more motor weakness and speech abnormalities, and also scored higher using the Dawson and DOT. The area under the curve (AUC) was 0.728 for DOT, with a sensitivity of 70.3% and specificity of 62.9%, respectively. In patients with transient neurological symptoms, our findings showed that the DOT score had relatively good calibration and discrimination to identify of TIA in a Chinese Population. As a novel tool of TIA identification, further validations are needed in multiple centers with larger samples in China.
最近，[短暂性脑缺血发作（TIA）诊断，DOT]评分已被公认为是一种让非专科医生更准确诊断TIA的新工具，其灵敏度和特异度分别为89%和76%。然而，在中国TIA患者中，DOT评分尚未在外部得到验证。我们回顾性纳入了500例连续的有短暂性神经症状的患者，这些患者于2016年1月至2018年12月入住北京朝阳医院神经内科并接受了磁共振成像（MRI）检查。有短暂性神经症状的患者被分为两个亚组：TIA模拟组（n = 140，28%）和确定性脑血管事件组，包括基于组织的TIA（弥散加权成像阴性，n = 252，50.4%）和轻度卒中（弥散加权成像阳性，n = 108，21.6%）。比较了两组之间的人口统计学数据、临床特征、实验室检查结果以及道森评分和DOT评分。共纳入500例有短暂性神经症状的患者（平均年龄61.1±12.8岁），70%（n = 350）为男性。与TIA模拟组相比，脑血管事件组患者更可能有更高的舒张压、尿酸和同型半胱氨酸水平，更多的运动无力和言语异常，并且使用道森评分和DOT评分时得分也更高。DOT评分的曲线下面积（AUC）为0.728，灵敏度分别为70.3%，特异度为62.9%。在有短暂性神经症状的患者中，我们的研究结果表明，DOT评分在识别中国人群中的TIA方面具有相对较好的校准和鉴别能力。作为一种识别TIA的新工具，在中国需要在多个中心进行更大样本量的进一步验证。
