基于CT脑血管造影的Maas评分与急性缺血性脑卒中患者介入治疗效果的相关性  

Correlation between Maas Score based on Cerebral CT Angiography and Outcome of Interventional Therapy in Patients with Acute Ischemic Stroke

作　　者：任思佳 严高武 REN Si-jia;YAN Gao-wu(Department of Radiology,Suining Central Hospital,Suining 629000,China)

机构地区：[1]遂宁市中心医院放射影像科,四川遂宁629000

出　　处：《南昌大学学报（医学版）》2022年第3期38-41,52,共5页Journal of Nanchang University：Medical Sciences

基　　金：四川省卫生健康委员会科研课题(19PJ284)。

摘　　要：目的探讨基于CT脑血管造影(CTA)的Maas评分与急性缺血性脑卒中(AIS)患者介入治疗效果的相关性。方法选取2017年6月至2020年6月遂宁市中心医院收治的AIS患者100例。根据CTA图像进行Maas评分,采用美国国立卫生院神经功能缺损评分(NIHSS)评估患者神经功能,采用改良Rankin量表(mRS)评估患者介入治疗30 d的治疗效果。采用Pearson相关分析Maas评分与NIHSS评分的相关性。应用多因素Logistic回归分析AIS患者介入治疗效果的影响因素,并绘制ROC曲线评估Maas评分对治疗效果的预估价值。结果mRS评估AIS患者治疗效果显示效果良好者46例、效果不良者54例,且效果不良者在年龄、再通时间、Maas评分≤2分的占比均高于效果良好者,但血管再通评分低于效果良好者(均P<0.05)。AIS患者Maas评分与NIHSS评分呈负相关(r=-0.674,P<0.001)。多因素Logistic回归分析显示,年龄、Maas评分、再通时间、血管再通评分是AIS患者治疗效果的影响因素(均P<0.05)。Maas评分预测治疗效果的ROC曲线下面积为0.835(95%CI:0.762~0.908),最佳临界值为4分,敏感度为0.88,特异度为0.74。结论Maas评分可较好地评估AIS患者的介入治疗效果,当Maas评分≥4分时,超窗AIS患者采取血管介入治疗仍可获得良好预后。Objective To investigate the correlation between Maas score based on cerebral CT angiography(CTA)and outcome of interventional therapy in patients with acute ischemic stroke(AIS).Methods A total of 100 AIS patients admitted to Suining Central Hospital from June 2017 to June 2020 were selected in this study.Maas scoring was performed according to the CTA images.The neurological function was evaluated by the National Institutes of Health Neurological Impairment Score(NIHSS),and the therapeutic outcome was assessed using the modified Rankin scale(mRS)after interventional therapy for 30 days.The correlation between Maas score and NIHSS score was analyzed by Pearson correlation test.Multivariate logistic regression was used to analyze the influencing factors of interventional therapy for AIS patients,and ROC curve was drawn to evaluate the predictive value of Maas score for treatment outcome.Results The mRS showed that the therapeutic effect was good in 46 cases,and poor in 54 cases.Compared with patients with good outcome,the age,recanalization time and proportion of Maas score≤2 increased but the recanalization score decreased in those with poor outcome(P<0.05).The Maas score of AIS patients was negatively correlated with the NIHSS score(r=-0.674,P<0.001).Multivariate logistic regression analysis showed that age,Maas score,recanalization time and vascular recanalization score were the factors influencing treatment outcome in AIS patients(P<0.05).The area under the ROC curve of Maas score for predicting treatment effect was 0.835(95%CI:0.762-0.908).The optimal threshold,sensitivity and specificity were 4,0.88 and 0.74,respectively.Conclusion Maas score can better evaluate the effect of interventional therapy in patients with AIS.When the Maas score is greater than or equal to 4,the patients outside the time window can still achieve a good prognosis.

关 键 词：急性缺血性脑卒中 CT脑血管造影 介入治疗 预测价值 

分 类 号：R743.3[医药卫生—神经病学与精神病学] R445.3[医药卫生—临床医学]