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纽约（路透社健康专栏）12月28日—根据一项最新研究表明，基于年龄、血压（BP）、临床表现及TIA症状（ABCD分数）的评分能够预测短暂性缺血发作（TIA）住院病人早期中风的高风险。

“来源于牛津夏州社区Stoke计划（ABCD评分）的简单评分系统能够帮助鉴定普通人群及临床住院病人中TIA发作后早期中风的高风险，”希腊雅典医学院Georgios Tsivgoulis博士及其同事们发表在《中风》杂志12月刊上的一篇研究报道。总共6分的ABCD评分系统按下列步骤进行：年龄小于60岁=0、60岁及其以上=1；体循环血压低于140mmHg同时舒张压低于90mmHg，评分=0，收缩压大于140mmHg和/或舒张压超过90mmHg，评分=1；单侧肢体麻痹=2，言语障碍但无口腔肌肉麻痹=1，其它症状=0；症状持续时间小于10分钟=0，10-59分钟=1，超过60分钟=2。研究人员对急诊室和5年间不断因TIA发作进行住院治疗的患者进行回顾性调查。ABCD评分系统用于预测30天内的中风风险。总共226名患者参与该研究。所有患者症状发作48小时内入院治疗。平均住院时间为8天。所有病人中，有22名患者（9.7%）根据TIA评分结果在30天内出现中风症状。

ABCD评分系统能够高度预测30天内的中风风险，Tsivgoulis及其同事们报道。ABCD评分为5-6，能够独立（P<0.001）预测30天内中风风险增加8倍以上（危险比为8.01）。“我们的研究结果验证了ABCD评分系统对住院TIA患者早期中风高风险的预测价值，并且提供更进一步的证据表明其临床应用前景，”作者总结道。


Simple Score Predicts Stroke Risk After Transient Ischemic Attack

NEW YORK (Reuters Health) Dec 28 - A score based on age, blood pressure (BP), clinical features, and duration of TIA symptoms (ABCD score) is predictive of patients hospitalized with transient ischemic attack (TIA) who are at high risk of early stroke, according to a new study.

"A simple score derived in the Oxfordshire Community Stoke Project (ABCD score) was able to identify individuals at high early risk of stroke after a TIA both in a population-based and a hospital-referred clinic cohort," Dr. Georgios Tsivgoulis and colleagues from the University of Athens School of Medicine, Greece, write in the December issue of Stroke.

The 6-point ABCD score works as follows: age younger than 60 years = 0, 60 years and older = 1; systolic blood pressure lower than 140 mm Hg and diastolic less than 90 mm Hg = 0, systolic greater than 140 mm Hg and/or diastolic greater than 90 mm Hg = 1; unilateral weakness = 2, speech disturbance without weakness = 1, other symptom = 0; duration of symptoms less than 10 minutes = 0, 10 to 59 minutes = 1, at least 60 minutes = 2.

The researchers retrospectively reviewed the emergency room and hospital records of consecutive patients hospitalized with a TIA during a 5-year period. The ABCD score was used to stratify the 30-day stroke risk.

A total of 226 patients were included in the study. All patients were hospitalized within 48 hours of symptom onset. The median length of hospital stay was 8 days. Overall, 22 patients (9.7%) had a subsequent stroke within 30 days of the index TIA.

The ABCD score was highly predictive of 30-day risk of stroke, Dr. Tsivgoulis and colleagues report. An ABCD score of 5 to 6 was independently (p < 0.001) associated with an 8-fold greater 30-day risk of stroke (hazard ratio, 8.01).

"Our findings validate the predictive value of the ABCD score in identifying hospitalized TIA patients with a high risk of early stroke and provide further evidence for its potential applicability in clinical practice," the authors conclude.

Stroke 2006;37:2892-2897.

http://www.medscape.com/viewarticle/550033



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