The Correlation Between Transient Ischemic Attack And Artery Stenosis With ABCD3-I Score And Prognosis Assessment

Objective To explore the relationship of risk stratification and cerebral artery stenosis distribution of90TIA patients with ABCD3-I score, To analysis the risk factors of different risk stratification with lipids, HbAlc, HCY, CRPH. We do this by utilizing with TIA type and history of seizures, hypertension history, diabetes history, smoking history and other risk factors for different risk stratification analysis. Follow-up statistics for selected patients with stroke incidence prognosis in90days.Methods Prospective study of90patients with TIA, according to ABCD3-I score and combined with MRI+DWI imaging and Carotid Ultrasound, dividing patients into3different risk stratifications (groups):0-3(low-risk group),4-7(medium-risk group) and8-13(high-risk group).According to the CTA, carotid ultrasound and transcranial Doppler imaging results to evaluate the correlation of different risk stratification of ABCD3-I score and cerebral artery stenosis distribution.90patients on admission were recording blood lipids (CHO, TG, LDL-C), HbAlc, HCY, CRPH, the first cluster analysisand principal component analysis, analysis of variance and LSD test for different risk stratification. To explore the relationship between the various laboratory parameters with different risk stratification.Recording90patients’ gender, age, length of stay, time of onset of symptoms, TIA typing, TIA history of seizures, hypertension, history of diabetes, smoking history, use logistic regression analysis to explore the relevance of several risk factors and risk stratification.Follow-up the same cases prognostic outcome to assess the risk of stroke of TIA patients within90days.ResultThe result of CTA shows the incidence of intracranial vascular stenosis is more than the incidence of carotid vascular stenosis,which take up for60.0%and25.6%respectively. The higher the stratification is, the higher the ratio of patients with intracranial arterial stenosis.CUS results have shown that the low risk group with carotid artery intimal thickening (45%), the high-risk group carotid artery with soft plaque formation (34.4%), that is, in the high-risk group of patients carotid vascular plaque usually unstable, easily to fall off, so that unstable plaque is more common in the high-risk group than lower risk group.TCD examination in the medium risk group and high-risk group were intracranial blood flow velocity anomaly-based,61.3%and74.1%, respectively, with the increase of risk stratification, intracranial artery blood flow velocity anomaly that the proportion of intracranial stenosisincreased. And the low-risk group have lower cerebral arterial elasticity that hardening of the blood vessel wall (55.0%).Low-risk and medium risk groups mainly were single vessel disease, and take up for85.0%and62.5%; the high risk group was mainly multivessel disease (78.6%), two groups in the narrow distribution of the proportion of the blood vessels supplying the difference.Different risk stratification of patients with blood lipid levers, especially low-density lipoprotein cholesterol (LDL-C) and triglyceride (TG) level showed distribution of significant difference, LDL-C and TG levels were also significantly increased with the increase of risk stratification. Total cholesterol (CHO) horizontal distribution was not statistically significant, the total cholesterol levels in patients with different risk stratification, also had no significant difference. HbAlc level statistical test, mainly the grouping compared with0-34-7grouping and8-13grouping (high-risk group) in patients with HbAlc level was significantly higher, as the risk stratification increased,HbAlc is gradually increased. Different risk stratification analysis showed that HCY levels4-7grouping and8-13group (high-risk group) HCY levels were significantly increased compared with the0-3grouping, with the risk stratification increased plasma HCY levels. Different risk stratification for patients with CRPH level statistical analysis shows no significant difference, which indicates that different risk stratification of patients with CRPH level was no significant difference.TIA type, attack history, history of hypertension and history of diabetes P<0.05, the difference was statistically significant. TIA seizure types and attack time of TIA onset and risk stratification. In comparison, patients’age, gender, length of stay, smoking history has little impact on the risk stratification.Within90days of stroke onset the results were18.9%, ABCD3-I score0-3group incidence was3.8%,4-7group was11.4%,8-13group was41.4%. The incidence of strokes were different in three different stratifications significant (P<0.05).Conclusion(1) cerebral artery stenosis is one of the major cause of TIA, ABCD3-I score in the high-risk group patients with intracranial arterial stenosis and the high incidence of unstable plaque (soft plaque, mixed plaque).(2) multi-vessel disease is an important consideration for TIA prognosis.(3) TIA patients with multiple cholesterol (LDL-C, TG), HbAlc, HCY change, and with the increased risk stratification, showed the index gradually increased.(4) TIA types, time of attack, relapse of attack, history of hypertension and history of diabetes onset were main risk factors of TIA patients with different risk stratification.(5) ABCD3-I score is an effective pathology of predicting the incidence of stroke in patients with TIA especially in the short-term progress of a clinical prediction. Different ABCD3-I risk stratification of patients has different prognosis, the higher incidence of cerebral infarction, the higher the risk stratification.