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目的探讨ABCD2+纤维蛋白原评分法对短暂性脑缺血发作后7d内发生脑梗死的预测价值。方法用ABCD2评分法和ABCD2+纤维蛋白原评分法分别测定135例TIA患者的评分,并观察TIA后7d内脑梗死的发生率。结果ABCD2+纤维蛋白原评分法和ABCD2评分法的曲线下面积(95%CI)分别为0.755(0.668~0.842)和0.711(0.618~0.804)。135例TIA患者中≤2分者13例,脑梗死的发生率为零;评分为3分者12例,脑梗死的发生率为8%;评分为4分者30例,脑梗死的发生率为17%;评分为5分者40例,脑梗死的发生率为25%;评分为6分者28例,脑梗死的发生率54%;评分≥7分者12例,脑梗死的发生率为58%。低危(0~3分)、中危(4~5分)和高危(6~8分)组TIA后7d内发生脑梗死的比例分别为4%、21%和55%(P<0.05)。结论ABCD2+纤维蛋白原评分法的预测价值高于ABCD2评分法。ABCD2+纤维蛋白原评分标准是临床上预测TIA短期进展为脑梗死的一种比较有效的方法。
Objective To investigate the predictive value of ABCD2 + fibrinogen score in cerebral infarction within 7 days after transient ischemic attack. Methods The score of 135 TIA patients was determined by ABCD2 score method and ABCD2 + fibrinogen score method. The incidence of cerebral infarction within 7 days after TIA was observed. Results The area under the curve (95% CI) of ABCD2 + fibrinogen score method and ABCD2 score method were 0.755 (0.668 ~ 0.842) and 0.711 (0.618 ~ 0.804) respectively. Thirteen of 135 TIA patients with ≤2 points had a zero incidence of cerebral infarction, 12 with a score of 3 and 8% with a cerebral infarction, 30 with a score of 4, and a significantly higher incidence of cerebral infarction Was 17%; score was 5 points in 40 cases, the incidence of cerebral infarction was 25%; score of 6 points in 28 cases, the incidence of cerebral infarction 54%; score ≥ 7 points in 12 cases, the incidence of cerebral infarction 58%. The incidence of cerebral infarction within 7 days after low-risk (0-3), moderate-risk (4-5) and high-risk (6-8) TIA were 4%, 21% and 55% . Conclusion The predictive value of ABCD2 + fibrinogen score method is higher than ABCD2 score method. The ABCD2 + Fibrinogen Scoring Standard is a more effective method for clinically predicting the short-term progression of TIA to cerebral infarction.