ABCD<sup>2</sup>评分联合血清和肽素 Lp-PLA<sub>2</sub>水平预测短暂性脑缺血发作7d内缺血性脑卒中发作的价值

doi:10.3969/j.issn.1006-6233.2025.08.027

摘要
图/表
参考文献
相关文章 (15)

全文: PDF (1222 KB) HTML (1 KB)
输出: BibTeX | EndNote (RIS)

摘要目的:探究ABCD²评分联合血清和肽素、脂蛋白相关磷脂酶(Lp-PL)A₂水平预测短暂性脑缺血发作(TIA)7d内患者预后的应用价值。方法:回顾性分析2020年1月至2023年12月114例TIA患者的临床资料,依据患者TIA发作7d内缺血性脑卒中(CIS)的发生情况分为CIS发生组(n=18)与CIS未发生组(n=96)。收集两组患者一般资料,采用ABCD²评分系统评估所有患者,并检测血清和肽素与Lp-PLA₂水平,采用多元Logistic回归模型分析影响TIA发作患者预后的独立危险因素,并采用受试者操作特征(ROC)曲线及最大约登指数分析各因素对TIA发作患者预后的预测价值。结果:CIS发生组ABCD²评分、血清和肽素与Lp-PLA₂水平高于CIS未发生组(P<0.05),Logistic回归分析结果显示ABCD²评分、和肽素、Lp-PLA₂均是影响TIA发作的独立危险因素,ROC曲线结果显示ABCD²评分、血清和肽素与Lp-PLA₂水平的曲线下面积(AUC)分别为0.779(0.702~0.855)、0.843(0.780~0.906)、0.760(0.681~0.838);各指标截断值分别为4分、174.34mg/L、16.49pmoL/L,联合预测的曲线下面积(AUC)为0.925(0.881~0.968),预测效能最高。结论:临床应对ABCD²评分>4分、血清和肽素水平>16.49pmoL/L、血清Lp-PLA₂>174.34mg/L的TIA发作患者采取预警措施,以防预后不良。

	服务

	把本文推荐给朋友
	加入我的书架
	加入引用管理器
	E-mail Alert
	RSS
	作者相关文章

关键词 ：短暂性脑缺血, ABCD²评分, 和肽素, 脂蛋白相关磷脂酶, 预后

Abstract：Objective: To explore the application value of ABCD² score combined with serum copeptin and lipoprotein-associated phospholipase (Lp-PL) A₂ levels in predicting the prognosis of patients with transient ischemic attack (TIA) within 7 days. Methods: The clinical data of 114 patients with TIA were retrospectively analyzed from January 2020 to December 2023. According to the occurrence of ischemic stroke (CIS) after TIA, the patients were divided into CIS occurrence group (n=18) and CIS non-occurrence group (n=96). The general data of the two groups were collected. The ABCD² scoring system was used to evaluate all patients, and the levels of serum copeptin and Lp-PLA₂ were detected. Multivariate Logistic regression model was used to analyze the independent risk factors affecting the prognosis of patients with TIA. Receiver operating characteristic (ROC) curve and the maximum Youden index were adopted to analyze the predictive value of each factor on the prognosis of patients with TIA. Results: The ABCD² score, serum copeptin and Lp-PLA₂ levels in the CIS occurrence group were higher than those in the CIS non-occurrence group (P<0.05). Logistic regression analysis showed that ABCD² score, copeptin and Lp-PLA₂ were independent risk factors for TIA. ROC curve results showed that the area under the curve (AUC) of ABCD² score, serum copeptin and Lp-PLA₂ levels were 0.779 (0.702~0.855), 0.843 (0.780-0.906) and 0.760 (0.681~0.838), respectively. The cut-off values of each index were 4 points, 174.34mg/L and 16.49pmol/L, respectively. The area under the curve (AUC) of combined prediction was 0.925 (0.881~0.968), and the prediction efficiency was the highest. Conclusion: Clinically, it is necessary to take early warning measures for TIA patients with ABCD² score>4point, serum copeptin level>16.49pmol/L and serum Lp-PLA₂>174.34mg/L to prevent poor prognosis.

Key words： Transient ischemic attack ABCD² score Copeptin Lp-PLA₂ Prognosis

基金资助:陕西省重点研发计划,(编号:2020SF-251);陕西省自然科学基础研究计划,(编号:2022JM-478)

引用本文:

杜赟, 范清雨, 卜宁, 张茹, 展淑琴, 巩雨, 李雯娴, 李曼. ABCD²评分联合血清和肽素 Lp-PLA₂水平预测短暂性脑缺血发作7d内缺血性脑卒中发作的价值[J]. 河北医学, 2025, 31(8): 1382-1386.
DU Yun, FAN Qingyu, Bu Ning, et al. Value of ABCD² Score Combined with Serum Copeptin and Lp-PLA₂ Levels on Predicting the Onset of Ischemic Stroke within 7 days of Transient Ischemic Attack. HeBei Med, 2025, 31(8): 1382-1386.

链接本文:

http://www.hbyxzzs.cn/CN/10.3969/j.issn.1006-6233.2025.08.027 或 http://www.hbyxzzs.cn/CN/Y2025/V31/I8/1382

[1] Fani L,Bos D,Mutlu U,et al.Global brain perfusion and the risk of transient ischemic attack and ischemic stroke:the rotterdam study[J].Am Heart Assoc,2019,8(7):11565.
[2] 中华医学会老年医学分会老年神经病学组,北京神经科学学会血管神经病学专业委员会,动脉粥样硬化性缺血性卒中/短暂性脑缺血发作合并冠心病诊治中国专家共识编写组.动脉粥样硬化性缺血性卒中/短暂性脑缺血发作合并冠心病诊治中国专家共识(2022)[J].中华医学杂志,2022,102(45):3569-3580.
[3] 短暂性脑缺血发作中国专家共识组.短暂性脑缺血发作的中国专家共识更新版(2011年)[J].中华危重症医学杂志(电子版),2012,5(2):100-105.
[4] 刘春洁,毕齐.ABCD²评分对短暂性脑缺血发作患者发生脑梗死风险的评估价值[J].临床神经病学杂志,2012,25(1):49-50.
[5] 中华医学会神经病学分会,中华医学会神经病学分会脑血管病学组.中国缺血性卒中和短暂性脑缺血发作二级预防指南2022[J].中华神经科杂志,2022,55(10):1071-1110.
[6] Perry JJ,Sivilotti MLA,Emond M,et al.Prospective validation of canadian TIA score and comparison with ABCD² and ABCD²i for subsequent stroke risk after transient ischaemic attack:multicentre prospective cohort study[J].BMJ,2021,372(3):49.
[7] Mendelson SJ,Prabhakaran S.Diagnosis and management of transient ischemic attack and acute ischemic stroke:a review[J].JAMA,2021,325(11):1088-1098.
[8] 中国老年学学会心脑血管病专业委员会,中国医师协会检验医师分会心脑血管病专家委员会.脂蛋白相关磷脂酶A2临床应用专家建议[J].中华心血管病杂志,2015,43(10):843-847.
[9] Li X,Xu L,Xu Z.The diagnostic and prognostic performance of Lp-PLA₂ in acute ischemic stroke[J].Med Clin (Barc),2021,156(9):437-443.
[10] Natochin YV,Golosova DV.Vasopressin receptor subtypes and renal sodium transport[J].Vitam Horm,2020,113(3):239-258.
[11] Mu D,Ma C,Cheng J,et al.Copeptin in fluid disorders and stress[J].Clin Chim Acta,2022,529(3):46-60.
[12] Brooks E,Bachmeier C,Vorster J,et al.Copeptin is increased by nausea and vomiting during hypertonic saline infusion in healthy individuals[J].Clin Endocrinol (Oxf),2021,94(5):820-826.
[13] Montellano FA,Ungethüm K,Ramiro L,et al.Role of blood-based biomarkers in ischemic stroke prognosis:a systematic review[J].Stroke,2021,52(2):543-551.
[14] Choy KW,Wijeratne N,Chiang C,et al.Copeptin as a surrogate marker for arginine vasopressin:analytical insights,current utility,and emerging applications[J].Crit Rev Clin Lab Sci,2025,62(1):24-44.