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目的探讨炎性标记物超敏-C反应蛋白(hs-CRP)与ABCD~3-Ⅰ评分联合预测短暂性脑缺血发作(TIA)后7 d内进展为脑梗死(CI)风险的价值。方法共121例临床资料完整的TIA患者纳入该研究,依据发病后7 d内是否发生CI分为CI组14例和TIA组107例。记录所有研究对象的常见脑血管病危险因素、hs-CRP水平、ABCD2及ABCD~3-Ⅰ评分等。应用单因素及多因素分析CI组和TIA组间常见脑血管病危险因素、hs-CRP水平、ABCD2、ABCD~3-Ⅰ评分等的差异性。应用受试者工作(ROC)曲线分析ABCD2、ABCD~3-Ⅰ评分及hs-CRP联合ABCD~3-Ⅰ评分预测TIA 7 d内发生CI风险的预测价值。结果单因素分析表明:与TIA组相比,CI组高血压史人数比例(71.4%vs.43.0%)、hs-CRP水平[(12.06±3.61)mg/L vs.(7.44±1.59)mg/L]、ABCD2评分(4.93±1.21 vs.3.71±1.52)、ABCD~3-Ⅰ评分(6.21±1.19 vs.4.19±2.19)均升高,差异均有统计学意义(均P<0.05)。多因素分析表明:CI组hs-CRP水平(OR=2.649,95%CI 1.529~4.588)、ABCD~3-Ⅰ评分(OR=3.046,95%CI1.148~8.081)均仍高于TIA组,差异均有统计学意义(均P<0.05),而两组之间高血压史人数比例和ABCD2评分均差异无统计学意义(均P>0.05)。ROC曲线分析表明:ABCD2、ABCD~3-Ⅰ评分及hs-CRP水平联合ABCD~3-Ⅰ评分预测CI发生的曲线下面积(AUC)分别为0.732、0.787、0.790。结论 ABCD~3-Ⅰ量表评分是一种简单、有效的TIA预后的预测工具,且hs-CRP与ABCD~3-Ⅰ评分联合能提高预测价值。
Objective To investigate the value of hs-CRP combined with ABCD 3-Ⅰ score in predicting the risk of developing cerebral infarction (CI) within 7 days after transient ischemic attack (TIA). Methods A total of 121 TIA patients with complete clinical data were included in the study. According to whether CI occurred within 7 days after onset, CI was divided into CI group (n = 14) and TIA group (n = 107). The common cerebrovascular disease risk factors, hs-CRP levels, ABCD2 and ABCD ~ 3-Ⅰ scores of all the subjects were recorded. Univariate and multivariate analysis were used to analyze the differences of common cerebrovascular disease risk factors, hs-CRP levels, ABCD2 and ABCD 3-Ⅰ scores between CI group and TIA group. The predictive value of CI risk in 7 days TIA was predicted by ROC curve analysis ABCD2, ABCD ~ 3-Ⅰ score and hs-CRP combined ABCD ~ 3-Ⅰ score. Results Univariate analysis showed that compared with TIA group, the percentage of hypertension patients in CI group (71.4% vs.43.0%) and hs-CRP level (12.06 ± 3.61 mg / L vs. 7.44 ± 1.59 mg / L], ABCD2 score (4.93 ± 1.21 vs.3.71 ± 1.52), ABCD ~ 3-Ⅰ score (6.21 ± 1.19 vs.4.19 ± 2.19), the differences were statistically significant (all P <0.05). Multivariate analysis showed that the levels of hs-CRP in CI group were still higher than those in TIA group (OR = 2.649, 95% CI 1.529-4.588), ABCD 3- 1 (OR = 3.046,95% CI 1.148-8.0881) (All P <0.05). There was no significant difference between the two groups in the number of hypertension history and ABCD2 scores (all P> 0.05). The ROC curve analysis showed that the area under the curve (AUC) of ABCD2, ABCD ~ 3-Ⅰ and hs-CRP combined with ABCD ~ 3-Ⅰ score predicting CI were 0.732,0.787 and 0.790 respectively. Conclusion The ABCD ~ 3-Ⅰ scale score is a simple and effective tool for predicting the prognosis of TIA. The combination of hs-CRP and ABCD 3-Ⅰ score can improve the predictive value.