艾森量表和精简的艾森量表预测中国非心房颤动性缺血性卒中患者复发的准确性  

Validation and Modification of the Essen Stroke Risk Scale in Stroke Patients of China

作　　者：付广荣[1] 员伟强 陈培豪[2] 林嵩艺[3] 李根玉 张彦芳[1] 田红军[1] 贺力男 郭爱武[1] 伊敬东 王志勇[1] 杜丽欣[1] 张佳丽[1] 李建梅[1] 许素娟[1] 吴红恩 翟晓薇[1] 张伟[1] 高丽[1] 杨丽梅[1] 付宝忠[1] 

机构地区：[1]衡水市第五人民医院,河北省衡水市1053000 [2]台湾马偕纪念医院神经科台北科技大学机电科技研究所 [3]华中科技大学同济医学院公共卫生学院流行病学与卫生统计系

出　　处：《中国卒中杂志》2011年第8期636-642,共7页Chinese Journal of Stroke

摘　　要：目的在非心房颤动型卒中患者中,验证艾森卒中风险评分量表(Essen Stroke Risk Scone,ESRS)预测卒中复发的准确性,将艾森卒中量表给予改良,并对改良后的艾森量表进行验证。方法分析连续住院治疗的510例脑梗死惠者的资料,依照艾森卒中量表给予评分,1年后随访到468例患者,按照随访结果将其分为复发组和未复发组,将复发纽和未复发组中的各个危险因素进行比较,根据结果 ,去掉无效题目,将艾森量表给予精简,并评价艾森量表和精简后的艾森量表的预测卒中复发的准确性。结果复发组201例和未复发组267例中,艾森卒中风险评分量表中的高血压(P=0.0010)、心脏病(P=0.0162)、吸烟(P=0.0220)、既往短暂性脑缺血发作或缺血卒中(P=0.0000)的比例差异有统计学意义,糖尿病在复发组和未复发组中的比例差异无统计学意义(P=0.07)。年龄(P=0.2565)、既往心肌梗死(P=0.5072)和外周动脉病(P=0.1578)的比例在两组惠者中的差异无统计学意义。精简的Essen量表删去了年龄、既往心肌梗死、外周动脉病3个无效的题目。精简的Essen量表预测卒中复发的受试者的工作特征(receiver operating characteritic,ROC)曲线下面积为0.645[95%(confidenceinterval,cl):0.596～0,695),完整的Essen量表预测卒中复发的ROC曲线下面积为0.650(95%Cl:0.601～0.699),均大于基准线的面积,两者的差异无统计学意义(P=0.8875)。结论 Essen量表可以用于预测卒中的复发,精简的Essen量表可以达到与完整的Essen量表相近的预测效果。Objective To retrospectively validate the prediction of the essen stroke risk score（ESRS） in nonatrial fibrillation patients with acute ischemic stroke hospitalized in a stroke unit of China, to modify it, and to investigate the prediction of the streamlined ESRS. Methods Five hundred and ten hospitalized patients with acute cerebral infarction were collected within 24 hours, and clinical follow-up were available in 468 cases after 12 months. The ESRS were analyzed in accordance with the follow-up results and were divided into recurrence group and the non-recurrence group. Basic demographic information and various risk factors were compared via statistical analysis in both groups. We modified the ESRS and validated the stroke recurrence rate of the ESRS with the streamlined ESRS. Results In recurrence group（N=20l） and the non-recurrence group（N=267）, four risk factors of ESRS, including hypertension（P=0.0010）, other heart disease（P=0.0162）, smoking（P=0.0220）,and previous transient ischemic attack or ischemic stroke, （P=0.0000） had significant difference （P〈0.05）. Three other risk factors, age（P=0.2565）, previous myocardial infarction（P=0.5072）, peripheral arterial disease（P=0.1578）, showed no significant difference between the two groups（P〉0.05）. The differences of recurrence rate in diabetic patient group and non-diabetic patient group closely reached to statistical significance（P=0.07）. The area under receiver operating characteristic（ROC） curve of the streamlined ESRS predicting the recurrence rate of stroke was 0.645（95%CI：0.596-0.695） and the area under ROC curve of the complete ESRS was 0.650（95%CI：0.601-0.699）. The difference was not statistically significant（P=0.8875〉0.05）. Conclusion In this study, the ESRS and the streamlined ESRS could predict the recurrence of stroke, which achieved similar prediction accuracies.

关 键 词：卒中 量表 复发 验证 预测 

分 类 号：R541.75[医药卫生—心血管疾病]