七种脑卒中筛查量表对急性缺血性脑卒中患者大血管闭塞的预测价值  

Value of seven stroke scale scores for predicting large vessel occlusion in AIS patients

作　　者：于善文 马春野[2] 孙大鹏 龚永安 胡峰 尹琳[2] Yu Shanwen;Ma Chunye;Sun Dapeng;Gong Yongan;Hu Feng;Yin Lin(Department of Intervention Therapy,the Third Affiliated Hospital of Jinzhou Medical University,Jinzhou 121000,Liaoning Province,China)

机构地区：[1]锦州医科大学附属第三医院介入科,121000 [2]大连医科大学附属第二医院神经科

出　　处：《中华老年心脑血管病杂志》2021年第11期1137-1140,共4页Chinese Journal of Geriatric Heart,Brain and Vessel Diseases

基　　金：大连市第二批领军人才资助项目(2018-192-66)。

摘　　要：目的探讨7种脑卒中筛查量表对大血管闭塞(large vessel occlusion,LVO)的预测价值。方法选择2016年9月~2018年9月于大连医科大学附属第二医院急诊神经科就诊的急性缺血性脑卒中患者110例,其中LVO 52例,应用美国国立卫生研究院卒中量表(NIHSS)、辛辛那提入院前卒中严重性量表(CPSSS)、脑卒中现场评估和分类转运量表(FAST-ED)、快速动脉闭塞量表(RACE)、院前急性脑卒中严重程度量表(PASS)、3项内容脑卒中量表(3-ISS)和洛杉矶运动量表(LAMS)对患者进行评分,单因素分析各量表评分与LVO相关性,用ROC曲线分析计算各量表预测LVO准度确。结果单因素分析显示,7种量表评分与LVO均具有相关性(P<0.05)。ROC曲线分析显示,7种量表评分中,NIHSS评分最佳临界值为8分时,预测LVO的准确度和敏感性最高,为87.0%和84.0%,特异性中等水平,为83.0%。CPSSS、PASS、3-ISS和LAMS评分的最佳临界值为2、2、2和3分时,预测LVO的特异性很高,分别为85.0%、87.0%、85.0%和84.0%;但准确度稍差,分别为81.0%、79.0%、82.0%、83.0%。FAST-ED和RACE评分的最佳临界值为4和5分时,准确度仅次于NIHSS评分,为84.0%和85.0%,同时敏感性、特异性均较高,为78.0%和84.0%、82.0%和75.0%。结论FAST-ED和RACE评分可迅速、高效识别LVO患者,并且准确度与NIHSS评分相当,有作为院前急救识别LVO脑卒中量表的条件。Objective To investigate the value of 7 stroke scale scores for predicting large vessel occlusion(LVO)in acute ischemic stroke(AIS)patients.Methods One hundred and ten AIS patients admitted to Affiliated Hospital of Dalian Medical University from September 2016 to September 2018 were assessed according to their NIHSS score,CPSSS score,FAST-ED score,RACE score,PASS score,3-ISS score and LAMS score respectively.The association between different stroke scores and LVO in AIS patients was analyzed by univariate logistic regression analysis.The accuracy of different stroke scales for predicting LVO in AIS patients were calculated by ROC curve nalysis.Results Univariate logistic regression analysis showed that the 7 stroke scale scores were related with LVO in AIS patients(P<0.05).ROC curve analysis displayed that the accuracy,sensitivity and specificity of NIHSS score for predicting LVO in AIS patients were 87.0%,84.0%and 83.0%respectively when its optimal cut-off score was 8.The accuracy of CPSSS score,PASS score,3-ISS score and LAMS score were 81.0%,79.0%,82.0%,83.0%respectively for predicting LVO in AIS patients when their optimal cut-off score were 2,2,2 and 3 respectively.The accuracy of FASE-ED score and RACE score were 84.0%and 85.0%respectively for predicting LVO in AIS patients,which were lower than that of NIHSS score.The sensitivity and specificity of FASE-ED score and RACE score for predicting LVO in AIS patients were 78.0%and 84.0%,82.0%and 75.0%respectively,which were higher than those of NIHSS score when their optimal cut-off score were 4 and 5 respectively.Conclusion FAST-ED scale score and RACE scale score can rapidly and effectively identify LVO with an accuracy comparable to the NIHSS score,and can thus used as first-aid indicators for identifying LVO in AIS patients.

关 键 词：卒中 血管疾病 动脉闭塞性疾病 ROC曲线 急救 

分 类 号：R743.3[医药卫生—神经病学与精神病学]