磁共振血管成像联合ABCD3-Ⅰ评分对TIA后继发脑梗死风险的预测价值分析

摘要 目的：分析磁共振血管成像（MAR）联合ABCD3-Ⅰ评分对短暂性脑缺血发作（TIA）后继发脑梗死风险的预测价值。方法：选取本院87例TIA患者，均行MAR检查及ABCD3-Ⅰ评分，随访90 d内继发脑梗死情况，分为继发脑梗死组与无脑梗死组，比较2组临床资料、MAR检查结果及ABCD3-Ⅰ评分，采用受试者工作特征曲线（ROC）分析MAR联合ABCD3-Ⅰ评分对脑梗死预测价值。结果：继发脑梗死组与无脑梗死组性别、年龄、BMI、吸烟史、饮酒史、糖尿病、高血压、房颤、高脂血症情况比较无统计学意义（P＞0.05）； 继发脑梗死组中度狭窄与严重狭窄-闭塞占比、ABCD3-Ⅰ评分高危占比高于无脑梗死组（P均＜0.001）；MAR检查、ABCD3-Ⅰ评分及二者联合预测曲线下面积（AUC）分别为0.863、0.827、0.942，联合预测具有较高预测效能，敏感度为100%，特异度为74.2%。结论：MAR联合ABCD3-Ⅰ评分对TIA后继发脑梗死具有较高预测效能，能够用于脑梗死的风险评估。

Predictive Value of Magnetic Resonance Angiography Combined with ABCD3-I Score for the Risk of Secondary Cerebral Infarction after TIA

ABSTRACT Objective: To analyze the predictive value of magnetic resonance angiography (MAR) combined with ABCD3-I score for the risk of secondary cerebral infarction after transient ischemic attack (TIA). Methods: A total of 87 patients with TIA in the hospital were enrolled, and all underwent MAR and ABCD3-I scoring. According to presence or absence of secondary cerebral infarction within 90d of follow-up, they were divided into infarction group and non-infarction group. The clinical data, MAR results and ABCD3-I score in the two groups were compared. The predictive value of MAR combined with ABCD3-I score for cerebral infarction was analyzed by receiver operating characteristic (ROC) curves. Results: There was no significant difference in gender, age, BMI, smoking history, drinking history, diabetes mellitus, hypertension, atrial fibrillation or hyperlipidemia between the two groups (P>0.05). The proportions of moderate to severe stenosis and occlusion, and high ABCD3-I score in infarction group were higher than those in non-infarction group (P<0.001). The area under the curve (AUC) values of MAR, ABCD3-I score and combined detection were 0.863, 0.827 and 0.942, respectively. The predictive efficiency of combined detection was high, and its sensitivity and specificity were 100% and 74.2%. Conclusion: MAR combined with ABCD3-I score has high predictive respectively for secondary cerebral infarction after TIA, which can be applied to evaluate the risk of cerebral infarction.