摘要
目的探讨超声造影评估颈动脉斑块新生血管分级联合ABCD评分预测短暂性脑缺血发作（TIA）进展为脑梗死的价值。方法对89例TIA患者颈动脉斑块行超声造影检查并参考文献对颈动脉斑块新生血管特点进行分级；依据患者临床特点对入选患者进行ABCD评分并分析比较不同ABCD评分患者进展为脑梗死的比率差异，应用Logistic回归对ABCD评分和颈动脉斑块新生血管分级与TIA进展为脑梗死的关系进行单因素和多因素分析，应用ROC曲线计算并比较ABCD评分、颈动脉斑块新生血管分级和二者联合预测TIA进展为脑梗死的敏感性、特异性和诊断效能。结果随TIA患者ABCD评分增加，TIA进展为脑梗死的比率明显增加（χ2=25．875，P=0．000）。TIA进展为脑梗死者ABCD评分较未进展者明显增加（4．14±1．17对2．68±1．12，t=-5．908，P=0．000）。ABCD评分和颈动脉斑块新生血管分级均是TIA进展为脑梗死的独立危险预测因素（均P〈0．05）（OR值分别为2．806，1．937）。以ABCD评分〉3分预测TIA进展为脑梗死的敏感性和特异性为69．4％，79．2％，以颈动脉斑块新生血管分级〉Ⅱ级预测TIA进展为脑梗死的敏感性和特异性为72．2％，73．6％，以二者联合诊断变量PRE_1〉0．239预测TIA进展为脑梗死的敏感性和特异性为86．1％，64．2％。二者联合诊断的曲线下面积最大（0．839，95％CI：0．746-0．909），颈动脉斑块新生血管分级的曲线下面积最小（0．703，95％CI：0．597～0．795），而ABCD评分的曲线下面积介于二者之间（0．807，95％CI：0．7090．883），二者联合诊断曲线下面积明显大于颈动脉斑块新生血管分级的曲线下面积（Z=2．473，P=0．0134）。结论TIA患者的危险分层应联合颈动脉斑块新生血管分级和ABCD评分进行分析。
Objective To evaluate the value of the combination of the grade of carotid plaque using contrast-enhanced ultrasonography（CEUS） and ABCD scores in the prediction from transient ischemic attack （TIA） to cerebral infarction. Methods The carotid plaques in 89 patients with TIA were studied by CEUS and the grade of carotid plaque was assessed according to the relevant literature. The ABCD scores were evaluated in enrolled patients and the rate of TIA to cerebral infarction was compared in different ABCD scores patients. The relations of ABCD scores and the grade of carotid plaque to TIA to cerebral infarction were analyzed using univariate and multivariate Logistic regression analysis. The sensitivity, specificity and diagnostic efficacy to the prediction from TIA to cerebral infarction for ABCD scores, the grade of carotid plaque and the combination of the above-mentioned two parameters were calculated and compared by ROC curve. Results The rate of TIA. to cerebral infarction was significantly increased when the ABCD scores increased （χ2 = 25.875, P = 0.000）. The ABCD scores were higher in patients from TIA to cerebral infarction than that in patients non-from TIA to cerebral infarction （4.14 ± 1.17 vs 2.68 ± 1.12,t = -5.91）8, P = 0.000）. The ABCD scores and the grade of carotid plaque were both independent risk marker for patients from TIA to cerebral infarction （OR value 2.806 and 1.937, respectively）. The sensitivity and specificity to predict the development from TIA to cerebral infarction by ABCD scores （cutoff value〉3） were 72.20/00,73.60/00, the sensitivity and specificity to predict the development from TIA to cerebral infarction by the grade of carotid plaque （cutoff value〉Ⅱ ） were 72.2%, 73.6%, and the sensitivity and specificity to predict the development from TIA to cerebral infarction by the combination parameters PRE 1 of the above mentioned two parameters （cutoff value〉0. 239） were 86.1%, 64.2%. The area under ROC curve（AUC） for the combination of the a
出处
《中华超声影像学杂志》
CSCD
北大核心
2016年第8期687-690,共4页
Chinese Journal of Ultrasonography
关键词
超声造影
脑缺血发作
短暂性
脑梗死
颈动脉
斑块
Contrast-enhanced ultrasonography
Ischemic attack, transient
Brain infarction
Carotid artery
Plaque
