短暂性脑缺血发作患者ABCD3-I评分与责任血管病变特点的关系及预后分析

Relationship between ABCD3-I score and characteristics of responsible vessels in patients with transient ischemic attack and prognosis analysis

摘要:

目的 探讨短暂性脑缺血发作（TIA）患者ABCD3-I评分与责任血管病变特点的关系及预后分析。方法 选取2015年1月—2018年6月于滁州市中西医结合医院脑病科收治的112例TIA患者，采用ABCD3-Ⅰ评分进行危险分层，分析不同危险分层与责任血管病变的关系，另通过Logistic回归模型探讨相关危险因素，随访患者3个月，统计其脑梗死发病率。结果 随着ABCD3-Ⅰ评分的增高，颅内动脉狭窄率呈升高趋势（P?<0.05），颈部血管狭窄呈下降趋势（P?<0.05）；颈部血管超声显示，内膜增厚（44.82%）是低危组颈部血管主要病理改变，中高危组主要表现为软斑形成（35.53%）；经颅多普勒检查提示低危组患者以脑动脉弹性降低为主（52.00%），中、高危组均以颅内血管血流速度异常为主（60.53%和72.73%）；低、中危组主要表现为单支血管病变（85.19%和62.50%），而高危组主要表现为多支血管病变（79.41%），同时各组供血动脉病变数比较，差异有统计学意义（P?<0.05）；Logistic回归分析发现，责任血管狭窄率≥50% [OlR=3.425（95% CI：1.402，8.956），P?=0.008]、单侧肢体无力[OlR=4.612（95% CI：1.572，12.876），P?=0.006]和不稳定斑块[OlR=3.243（95% CI：1.276，7.124），P?=0.001]是90?d内进展为脑梗死的独立危险因素（P?<0.05）。各组卒中发生率比较，差异有统计学意义（P?<0.05）。结论 TIA患者ABCD3-I评分能够反映患者血管的狭窄程度、斑块性质及血管病变支数，结合危险因素能够早期防治脑梗死。

Abstract:

Objective To investigate the relationship between transient ischemic attack (TIA) and ABCD3-I score. Methods The clinical and imaging data of 112 patients with TIA were retrospectively analyzed, using ABCD3 - I score to risk stratification, analyzing the relationship of the different risk stratification with responsible vascular lesions. The other characters were analyzed by Logistic regression analysis to explore related risk factors. After the follow-up of patients for 3 months, the incidence of cerebral infarction was recorded. Results As the ABCD3 - I score increasing, intracranial artery stenosis rate also increased (P?