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目的分析联合应用ABCD2评分和头颈部CT血管成像(CTA)对短暂性脑缺血发作(TIA)后短期发生脑梗死的预测价值。方法选取TIA患者153例,就诊后行ABCD2评分和CTA检查,入院1、2、7d检查MR,评估脑梗死的发生率。结果 153例中,依据ABCD2评分标准,低危50例,中危59例,高危44例;TIA发病1、2、7d,低危患者脑梗死发生率分别为2.0%、2.0%、8.0%;中危患者脑梗死发生率分别为8.5%、16.9%、27.1%;高危患者脑梗死发生率分别为18.2%、34.1%、47.7%;差异有统计学意义(P<0.05)。依据头颈部CTA,颈部血管轻度狭窄65例,中度狭窄47例,重度狭窄或闭塞41例;中、重度狭窄或闭塞患者脑梗死发生率高于轻度狭窄患者(P<0.05)。ABCD2评分中、高危患者颈部血管重度狭窄或闭塞的发生率高于低危患者(P<0.05)。结论联合应用ABCD2和头颈部CTA可以提高预测TIA患者7d内脑梗死的发生率。
Objective To analyze the predictive value of combined ABCD2 score and head and neck CT angiography (CTA) for short-term cerebral infarction after transient ischemic attack (TIA). Methods TIA patients were selected 153 cases, after treatment ABCD2 score and CTA examination, admission 1,2,7 d check MR, assess the incidence of cerebral infarction. Results In 153 cases, according to ABCD2 score criteria, there were 50 cases in low risk, 59 cases in intermediate risk and 44 cases in high risk. The incidence of cerebral infarction was 2.0%, 2.0% and 8.0% in low risk patients at 1, 2 and 7 days after TIA. The incidence of cerebral infarction in patients with moderate risk were 8.5%, 16.9% and 27.1%, respectively. The incidence of cerebral infarction in high risk patients was 18.2%, 34.1% and 47.7% respectively. The difference was statistically significant (P <0.05). According to the head and neck CTA, neck stenosis was mild in 65 cases, moderate stenosis in 47 cases, and severe stenosis or occlusion in 41 cases. The incidence of cerebral infarction in patients with moderate or severe stenosis or occlusion was higher than that in patients with mild stenosis (P <0.05) . ABCD2 score, high-risk patients with severe cervical vascular stenosis or occlusion was higher in patients with low risk (P <0.05). Conclusion The combination of ABCD2 and CTA can improve the incidence of cerebral infarction within 7 days in TIA patients.