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短暂性脑缺血发作后脑梗死风险预测的研究:一项遵循STROBE规范的研究。

Study on the risk prediction for cerebral infarction after transient ischemic attack: A STROBE compliant study.

作者信息

Zhang Chenhao, Zang Yanjing, Hu Lei, Song Qin, Zhao Weidong, Zhang Chunliang, Liu Hongshun, Gu Fang

机构信息

Department of Neurology.

Department of Geriatric.

出版信息

Medicine (Baltimore). 2020 Mar;99(11):e19460. doi: 10.1097/MD.0000000000019460.

Abstract

Transient ischemic attack (TIA) is often recurrent, and about one-third of patients will progress to cerebral infarction. Rapidly identifying high-risk patients is pivotal to prevent the development of cerebral infarction. Therefore, this study aimed to evaluate the value of ABCD score, ABCD score combined with magnetic resonance diffusion weighted imaging (DWI) and intracranial arterial magnetic resonance angiography (MRA) in predicting cerebral infarction after 2 to 30 days of transient ischemic attack (TIA).182 patients with TIA from August 2011 to August 2014 were enrolled as study subjects, and their clinical data, test results of DWI and MRA were collected. The incidence of cerebral infarction was observed at 2 days, 7 days and 30 days after TIA in patients with TIA, through scoring according to the 7-point ABCD score method proposed by Johnston. The relationship between ABCD score, performances of DWI and MRA and the early incidence of cerebral infarction after TIA was analyzed. The accuracy rating of ABCD score and ABCD + DWI + MRA score used for predicting the early incidence of cerebral infarction after TIA were compared with each other.The incidence of cerebral infarction after TIA was 19 cases (10.4%) in 2 days, 42 cases (23.1%) in 7 days, 56 cases (30.8%) in 30 days respectively. For the ABCD score of incidence of cerebral infarction 2 to 30 days after TIA, that of those with high risk was higher than that with medium risk, and that with the medium risk was higher than that with low risk (P < .05). The area under the curve of ABCD + DWI + MRA score and ABCD score predicting the incidence of cerebral infarction was: in 2 days: 0.782 and 0.748, in 7 days: 0.839 and 0.801, in 30 days: 0.780 and 0.757, P < .05.Compared with ABCD score, ABCD score combined with DWI and MRA can further improve the accuracy of prediction for cerebral infarction after TIA.

摘要

短暂性脑缺血发作(TIA)常反复发作,约三分之一的患者会进展为脑梗死。快速识别高危患者对于预防脑梗死的发生至关重要。因此,本研究旨在评估ABCD评分、ABCD评分联合磁共振扩散加权成像(DWI)及颅内动脉磁共振血管造影(MRA)在预测短暂性脑缺血发作(TIA)后2至30天发生脑梗死的价值。选取2011年8月至2014年8月的182例TIA患者作为研究对象,收集其临床资料、DWI及MRA检查结果。按照Johnston提出的7分制ABCD评分法对TIA患者进行评分,观察TIA患者在TIA后2天、7天及30天脑梗死的发生率。分析ABCD评分、DWI及MRA表现与TIA后脑梗死早期发生率之间的关系。比较用于预测TIA后脑梗死早期发生率的ABCD评分及ABCD + DWI + MRA评分的准确性。TIA后2天脑梗死发生率为19例(10.4%),7天为42例(23.1%),30天为56例(30.8%)。对于TIA后2至30天脑梗死发生率的ABCD评分,高危组高于中危组,中危组高于低危组(P<0.05)。ABCD + DWI + MRA评分及ABCD评分预测脑梗死发生率的曲线下面积分别为:2天时:0.782和0.748;7天时:..839和0.801;30天时:0.780和0.757,P<0.05。与ABCD评分相比,ABCD评分联合DWI及MRA可进一步提高预测TIA后脑梗死的准确性。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/e2f9/7220422/323be9ae1d83/medi-99-e19460-g005.jpg

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