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目的分析以短暂性脑缺血发作(TIA)为特殊临床表现的急性脑梗死患者再发卒中相关因素,并评价ABCD2卒中评分量表联合磁共振检查对此类特殊临床表现的脑梗死患者再发卒中风险的预测价值。方法收集2014年1月—2016年10月在该院神经内科住院的以TIA为临床表现的急性脑梗死患者72例,随访患者7 d及90d内缺血性卒中复发率,分析卒中复发的相关危险因素,以及复发情况与磁共振血管成像(MRA)结果和ABCD2评分数值的关系。结果以发作性症状为特殊临床表现的急性脑梗死患者7d及90d内脑梗死的再发率分别为6.9%和11.1%。磁共振检查血管存在明显狭窄(≥50%)的患者7d和90d内脑梗死的发生率较血管无明显狭窄(<50%)明显增高。ABCD2评分预测7d及90d内脑梗死复发风险分层能力,采用曲线下面积(Area Under the Curve AUC)值来评定预测效度,二者分别为0.805、0.768。结论磁共振血管成像(MRA)检查能较好的预测患者7d及90d内再发脑梗死风险,ABCD2量表评分对7d及90d内脑梗死再发有一定的预测价值,而二者联合对90d内脑梗死复发率预测价值更高。
Objective To analyze the related factors of recurrent stroke in patients with acute cerebral infarction with special clinical manifestations of transient ischemic attack (TIA) and to evaluate the relapse of ABCD2 stroke scoring system combined with magnetic resonance imaging in patients with such special clinical manifestations of cerebral infarction Predictive value of stroke risk. Methods 72 patients with acute cerebral infarction (TIA) who were hospitalized in neurology department of our hospital from January 2014 to October 2016 were recruited. The relapse rate of ischemic stroke on the 7th and 90th follow-up was analyzed and the relapse of stroke was analyzed Risk factors, and relapse with magnetic resonance angiography (MRA) results and ABCD2 score values. Results The recurrent rate of cerebral infarction in patients with acute cerebral infarction with special clinical manifestations of seizures was 6.9% and 11.1% within 7 days and 90 days, respectively. In patients with significant stenosis (≥50%) in MRI, the incidence of cerebral infarction within 7d and 90d was significantly higher than those with no significant stenosis (<50%). The ABCD2 score predicted the stratification ability of recurrent cerebral infarction within 7d and 90d, and the predictive validity was evaluated by Area Under the Curve AUC, which were 0.805 and 0.768 respectively. Conclusion Magnetic resonance angiography (MRA) can better predict the risk of recurrent cerebral infarction within 7 days and 90 days. The score of ABCD2 has some predictive value for recurrent cerebral infarction within 7 days and 90 days. However, Recurrence rate of intracerebral infarction is more predictive value.