目的 基于Logistic回归和ROC曲线分析不同评分方法对预测短暂性脑缺血发作(TIA)后近期继发脑梗死风险的临床价值.方法 选择256例 TIA的患者作为研究对象,所有患者均采用ABCD2及ABCD3-Ⅰ行继发脑梗死风险评估,随访3个月记录患者继发脑梗死的发生率,采用Logistic回归和ROC曲线分析上述评分方法临床价值.rn结果 随访3个月,256例TIA患者中有45例患者继发脑梗死,占17.6%.继发脑梗死组高脂血症、症状持续时间≥60 min、双重TIA、同侧颈动脉狭窄≥50.0%及DWI高信号比例高于未继发组,差异有统计学意义（P<0.05）.校正相关因素后,Logistic回归分析发现症状持续时间≥60 min、双重TIA、同侧颈动脉狭窄≥50.0%及DWI高信号是继发脑梗死发生的危险因素（P<0.05）.以继发脑梗死发生为金标准绘制ROC曲线发现:ABCD2评分的AUC为0.697,截断值为5.42；ABCD3-Ⅰ评分的AUC为0.914,截断值为6.34.ABCD2的漏诊率为26.7%,明显高于ABCD3-Ⅰ的漏诊率8.9%,差异有统计学意义（P<0.05）.rn结论 ABCD3-Ⅰ评分预测TIA患者继发脑梗死准确率高,漏诊率低,有更好的临床应用价值.%Objective To analyze the value of different grading method in predicting the risk of wtroke after transient ischemic attack(TIA) based on logistic regression and ROC curve.Methods The clinical data and imaging data of 256 consecutive patients with TIA were collected in this research．All patients were evaluated according to ABCD2 and ABCD3-Ⅰcriteria．The predictive power of prognostic scores were determined by using area under receiver operator characteristic curve（AUC）analysis，and ABCD2 and ABCD3-Ⅰ score were used in predicting early stroke risk after TIA. Results Forty-five TIA patients （17.6％） developed ischemic stroke within three months. Hyperlipidemia, symptom duration≥60 min, double TIA, ipsilateral carotid stenosis≥50.0% and DWI high signal in secondary cerebral infarction group were higher than those in non-secondary cerebral infarction group. The difference were statistically significant (P<0.05). Logistic regression analysis found that symptom duration≥60 min, double TIA, ipsilateral carotid stenosis≥50.0% and DWI high signal were risk factors for secondary cerebral infarction occurred (P<0.05). When the occurrences of stroke were observed in three months, the AUC of ABCD2 and ABCD3-Ⅰ scores were 0.697 and 0.914, and the cut-off value were 5.42 and 6.34,respectively. The missed diagnosis rate for ABCD2 was 26.7%, which was higher than 8.9% for ABCD3-Ⅰ score. The difference was statistically significant (P<0.05).Conclusion ABCD3-Ⅰ score is more accurate in predicting early risk of stroke after TIA than ABCD2 score, and it has higher clinical value．
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