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目的分析ABCD2评分结合经颅多普勒和颈部血管超声对短暂性脑缺血发作(TIA)后7 d发生脑梗死的评估价值。方法以2010年1月～2011年1月住院治疗的126例TIA患者作为研究对象,收集其临床、TCD和颈部血管超声检查资料。按ABCD2评分法进行评分,计算TIA后7 d内脑梗死发生率。结果 126例TIA患者7 d内进展为脑梗死者26例,占20.6%。ABCD2评分越高,脑梗死的发生率越高(P<0.05)。TIA后7 d脑供血动脉狭窄≥50%的患者中脑梗死发生率较脑供血动脉狭窄<50%的患者明显升高(P<0.05)。ABCD2评分≥4分、脑供血动脉狭窄≥50%的TIA患者7 d脑梗死发生率为33.8%,与ABCD2评分≥4分、脑供血动脉狭窄<50%的TIA患者(7.7%)比较,其发生脑梗死的风险明显增加(P<0.05)。结论 ABCD2评分法预测7 d发生脑梗死风险的准确性较高,进一步结合经颅多普勒和颈部血管超声检查可提高预测的准确性。
Objective To evaluate the diagnostic value of ABCD2 combined with transcranial Doppler and cervical vascular ultrasound in cerebral infarction at 7 days after transient ischemic attack (TIA). Methods A total of 126 TIA patients hospitalized from January 2010 to January 2011 were enrolled in this study. The data of clinical, TCD and neck vascular ultrasonography were collected. According to the ABCD2 score method, the incidence of cerebral infarction was calculated within 7 days after TIA. Results 126 cases of TIA patients within 7 days of cerebral infarction in 26 cases, accounting for 20.6%. The higher the ABCD2 score, the higher the incidence of cerebral infarction (P <0.05). The incidence of middle cerebral infarction in cerebral artery stenosis ≥50% 7 days after TIA was significantly higher than that in cerebral arterial stenosis <50% (P <0.05). The incidence of 7-day cerebral infarction was 33.8% in TIA patients with ABCD2 score> = 4 and cerebral arterial stenosis≥50%. Compared with TIA patients (7.7%) with ABCD2 score> 4 points and cerebral arterial stenosis <50% The risk of cerebral infarction increased significantly (P <0.05). Conclusion The accuracy of ABCD2 score in predicting the risk of cerebral infarction on the 7th day is high. Combined with transcranial Doppler and ultrasonography of the neck vessels, the predictive accuracy can be improved.