ABCD2评分联合血浆同型半胱氨酸水平检测在短暂性脑缺血发作风险评

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ABCD2评分联合血浆同型半胱氨酸水平检测在短暂性脑缺血发作风险评估中的应用

作者：李静李长清

来源：《中国医药导报》2016年第13期

[摘要] 目的探讨ABCD2评分联合血浆同型半胱氨酸（Hcy）水平检测在短暂性脑缺血发作（TIA）风险评估中的应用效果。方法回顾性分析2013年1月～2015年1月重庆市重钢总医院80例TIA患者的临床资料，所有患者均采用ABCD2评分对患者的病情进行分层，同时检测患者血浆Hcy水平，观察比较不同ABCD2评分、血浆Hcy TIA 7 d内脑梗死发生情况，绘制ROC分析不同检测方法预测TIA 7 d内脑梗死发生风险的曲线下面积（AUC）。结果随着ABCD2评分升高，Hcy水平及TIA 7 d内脑梗死发生率均逐渐升高，ABCD2评分高危和中危者Hcy水平及TIA 7 d内脑梗死发生率[高危：（19.82±4.74）μmol/L、40.0%；中危：（17.22±4.15）μmol/L、25.0%]均明显高于低危者[（10.58±3.43）μmol/L、9.5%]，差异有统计学意义（P < 0.05）；ABCD2评分中、高危者Hcy水平比较，差异无统计学意义（P >

0.05），而TIA 7 d内脑梗死发生率差异有高度统计学意义（P < 0.01）。随着Hcy水平的逐渐升高，TIA 7 d内脑梗死的发病率也逐渐升高，Hcy水平10～

[关键词] 短暂性脑缺血发作；同型半胱氨酸；ABCD2评分；脑梗死；风险评估

[中图分类号] R743.3 [文献标识码] A [文章编号] 1673-7210（2016）05（a）-0036-04

[Abstract] Objective To explore the application effect of ABCD2 score combined with detection of plasma homocysteine （Hcy） levels in the risk assessment of transient ischemic attack （TIA）. Methods Clinical data of 80 patients with TIA from January 2013 to January 2015 in General Hospital of Chongqing Iron and Steel Company were analyzed retrospectively， all patients were given the ABCD2 score， and plasma homocysteine levels of all patients were detected at the same time；incidence of patients with different levels of plasma homocysteine and ABCD2 score was observed and compared， ROC curve was drawn and the AUC of different detection method were used to predict the risk assessment of brain infarction within 7 d after TIA. Results With the increasing of ABCD2 score， Hcy levels and incidence of brain infarction within 7 d after TIA increased， levels of Hcy and incidence of brain infarction within 7 d after TIA of patients with high and medium risk of ABCD2 score [high risk：（19.82±4.74）μmol/L， 40.0%； medium risk：（17.22±4.15）

μmol/L， 25.0%] were significantly higher than those of low risk [（10.58±3.43）μmol/L，

9.5%]， the differences were statistically significant （P < 0.05）； there was no statistically significant difference between patients with medium risk and high risk of ABCD2 score （P >

0.05）， while within 7 d after TIA brain infarction incidence differences apparent， the difference was statistically significant （P < 0.01）. With the rising of Hcy levels， incidence of brain infarction