iScore、PLAN和ASTRAL评分对急性缺血性卒中患者不良结局风险预测价值探讨  

External Validation of the iScore, PLAN Score and ASTRAL Score to Predict Functional Outcomes for Acute Ischemic Stroke

作　　者：金迪[1] 陈忠云[1] 李婧[1] 李珊珊[1] 徐志伟[1] 杜继臣[1] 杨旭[1] 

机构地区：[1]北京大学航天临床医学院神经内科,北京100049

出　　处：《神经损伤与功能重建》2014年第3期209-213,共5页Neural Injury and Functional Reconstruction

摘　　要：目的:探讨国外iScore、PLAN和ASTRAL评分对我国急性缺血性卒中(AIS)患者3个月的不良结局预测价值。方法:前瞻性收集2012年12月至2013年8月在我科住院的AIS患者221例,记录有关基线资料,并使用3个量表进行评分。以卒中后3个月出现死亡或功能残障(改良Rankin评分≥3分)作为不良预后事件。通过受试者工作特征曲线下面积(AUC)比较3个量表的预测价值;使用Hosmer-Lemeshow法判断模型的拟合优度;应用Pearson相关分析评估实际与预期结局事件的关联程度。结果:在AIS后3个月,71例(32.1%)出现不良预后。iScore、PLAN和ASTRAL评分的AUC分别为0.816、0.830和0.841;Hosmer-Lemeshow法x2值分别为1.676、5.976和12.858(均P>0.05);Pearson相关系数分别为0.899、0.857和0.939(均P<0.05)。结论:iScore、PLAN和ASTRAL量表对AIS患者3个月发生不良事件的风险预测能力强,与预期结局事件关联程度高。ObjectiveTo validate the significance of iScore, PLAN score and ASTRAL score in predicting the outcome of Chinese patients at 3 month after acute ischemic cerebral stroke （AIS）. Methods： From December 2012 to August 2013, 221 AIS patients who hospitalized in neurology department of our hospital were collected prospectively. Related baseline data were recorded and calculated by iScore, PLAN score and ASTRAL score. The outcome events were defined as death and poor functional outcome, or modified Rankin Scale （≥3）. Model discrimination was quantified by calculating the area under the Receiver Operating Characteristic curve （AUC）, and calibration was assessed by goodness of fit test and correlation coefficient. Results： Seventy-one cases （32.1%） had 3-month an unfavorable outcome. AUC for iScore, PLAN score and ASTRAL score were 0.816, 0.830 and 0.841 respectively.x^2 of were 1.676, 5.976 and 12.858 （all P〉0.05）, and correlation coefficient were 0.899, 0.857 and 0.939 （all P〈0.05）, respectively. Conclusion： All the three scales can predict 3-month functional outcomes in Chinese stroke patients precisely and reliably. There was a high correlation between observed and expected probability of unfavorable outcome.

关 键 词：缺血性卒中 预后 量表 受试者工作特征曲线 

分 类 号：R741[医药卫生—神经病学与精神病学] R741.04[医药卫生—临床医学]