两种评分系统在原发性脑桥出血预后评估中的效果对比  

Comparison of two scoring systems in the prognosis evaluation of primary pontine hemorrhage

作　　者：林斌[1] 温江[1] 何俊[1] 魏平波[1] 陈浩[1] 

机构地区：[1]绵竹市人民医院神经外科,四川618200

出　　处：《社区医学杂志》2017年第16期22-24,26,共4页Journal Of Community Medicine

摘　　要：目的探讨两种评分系统在原发性脑桥出血(primary pontine hemorrhage,PPH)患者预后评估中的效果对比。方法抽取2013年1月—2017年1月原发性脑桥出血住院患者49例,采用PPH评分、格拉斯哥昏迷(Glasgow Coma Scale,GCS)评分统计患者一般临床资料情况,以改良Rankin分级(modified Rankin Scale,m RS)预后评定死亡组和存活组,对比两组临床资料,采用受试者工作特征曲线(receiver operating characteristic,ROC)评价PPH评分预测患者死亡发生的准确性。计量资料比较采用t检验,计数资料比较采用χ2检验,P<0.05为差异有统计学意义。结果死亡组GCS评分(5.0±2.4)分低于存活组(12.7±3.3)分,死亡组血糖(9.8±3.4)mmol/L高于存活组(7.6±1.6)mmol/L,比较差异有统计学意义(均P<0.05);在是否存在瞳孔对光反射及PPH评分等方面比较,差异有统计学意义(均P<0.05)。PPH评分预测原发性脑桥出血患者死亡发生的曲线下面积为0.917,敏感度为79.3%,特异性为90%。结论 PPH评分预测原发性脑桥出血的准确性、敏感性及特异性高。Objective To compare the effect of two scoring systems in the prognosis of patients with primary pontine hemorrhage. Methods Forty-nine cases of primary pontine hemorrhage from January 2013 to January 2017 were collected. PPH score and Glasgow coma （Glasgow, Coma, Scale, GCS） score were used to calculate the general clinical data of the patients. The death and survival groups were evaluated with improved Rankin classification （modified, Rankin, Scale, mRS）. The clinical data of the two groups were compared. Characteristic operating （receiver） ROC curve was used to evaluate the accuracy of the PPH score in pre- dicting the death of the patients. Measurement data were compared with t test, count data were compared with Ztest. P〈0.05 was considered statistically significant. Results The GCS score （5.0-2.4） in the death group was lower than, that in the survival group （12.7-3.3）. The blood glucose [（9.8＋3.4） mmol/L] in the death group was higher than that in the survival group [（7.＇6-1.6） mmol/L]. The difference was Statistically significant （P〈0.05）. There were significant differences in the presence of pupillary light reflex and PPH score （P〈0.05）. The PPH score predicts that the area under the curve of death in patients with primary pontine hemorrhage is 0.917. The sensitivity was 79.3% and the specificity was 90%. Conclusions The PPH score is accurate, sensitive and specific for predicting primary pontine hemorrhage.

关 键 词：原发性脑桥出血 PPH评分 预后 

分 类 号：R743.34[医药卫生—神经病学与精神病学]