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目的探讨ABCD2评分预测短暂性脑缺血发作(TIA)后发生脑梗死的风险。方法收集118例以头昏为主要症状患者的临床资料。对所有患者在首诊时使用ABCD2评分进行评价,并将入组者分为低危组(1~3分),中危组(4~5分)和高危组(6~7分)。入组患者均在入组后即进行头颅CT检查,在48~72 h内进行核磁共振成像检查,观察弥散加权序列是否出现高信号,以确定是否发生脑血管病事件。出院后对入组者进行长达6个月的随访,观察脑血管事件的发生率。结果入组118例患者,其中男57例,女61例;年龄62-77岁,平均年龄(65.8±11.6)岁。高危组37例,中危组29例,低危组52例。经证实入组患者中15例(12.7%)发生脑血管病事件,经影像学证实均为脑梗死。高危组中11例(29.7%)发生脑梗死,中危组3例(10.3%)发生脑梗死,而低危组患者在随访观察期内仅有1例(1.9%)发生脑梗死,3组间差异具有显著统计学意义(P<0.01)。结论 ABCD2评分系统可有效预测头昏患者发生脑血管病事件的风险。该评分方法的应用对早期干预,预防缺血性脑血管疾病的进展,改善预后有积极意义。
Objective To investigate the ABCD2 score predicts the risk of cerebral infarction after transient ischemic attack (TIA). Methods A total of 118 cases of patients with dizziness as the main clinical data were collected. All patients were evaluated by ABCD2 at the first visit, and the patients were divided into low risk group (1 to 3), moderate risk group (4 to 5) and high risk group (6 to 7). Patients were enrolled into the group after the head CT examination, within 48 ~ 72 h of magnetic resonance imaging examination to see whether the diffusion weighted sequence high signal to determine whether the occurrence of cerebrovascular disease events. After discharge, the patients were followed up for 6 months to observe the incidence of cerebrovascular events. Results A total of 118 patients, including 57 males and 61 females, aged 62-77 years and mean age (65.8 ± 11.6 years). 37 cases were in high risk group, 29 in middle risk group and 52 in low risk group. 15 patients (12.7%) were confirmed as having cerebrovascular disease and confirmed by imaging to be cerebral infarction. Cerebral infarction occurred in 11 patients (29.7%) in the high-risk group and in 3 (10.3%) in the intermediate-risk group, whereas in the low-risk group only 1 (1.9%) developed cerebral infarction during the follow-up observation period. There was significant difference between the two groups (P <0.01). Conclusion ABCD2 scoring system can effectively predict the risk of dizziness patients with cerebrovascular disease. The application of the scoring method is of positive significance for early intervention, preventing the progression of ischemic cerebrovascular disease and improving the prognosis.