应用重庆卒中评分预测腔隙性卒中患者短期不良预后风险  

External Validation of Chongqing Stroke Scale to Predict Short-Term Functional Outcomes of Patients with Lacunar Stroke

作　　者：金迪[1] 李芹[1] 吴月霞 朱慧 单勇[1] 刘海超[1] 王起[1] 张绿明[1] 王培福[1] 杨静[1] JIN Di;LI Qin;WU Yue-xia;ZHU Hui;SHAN Yong;LIU Hai-chao;WANG Qi;ZHANG Lv-ming;WANG Pei-fu;YANG Jing(Department of Neurology,Aerospace Center Hospital,Beijing 100049,China;Graduate School of Hebei Medical University,Shijiazhuang 050030,China)

机构地区：[1]航天中心医院神经内科,北京100049 [2]河北医科大学研究生学院,石家庄050030

出　　处：《神经损伤与功能重建》2022年第10期571-574,共4页Neural Injury and Functional Reconstruction

基　　金：航天科工集团医疗卫生科研项目(No.2020-LCYL-003)。

摘　　要：目的:探讨重庆卒中评分(CQSS)对腔隙性卒中(LS)患者的短期不良预后及早期神经功能缺损进展(END)的预测价值。方法:前瞻性纳入2020年6月1日至2021年5月31日期间在航天中心医院神经内科住院的LS患者294例,记录患者基线资料,并进行CQSS评分;主要结局事件为出院时不良预后(改良Rankin评分≥3分),次要结局事件为出现END;通过受试者工作特征曲线下面积(AUC)判断CQSS对结局事件的预测价值。结果:根据出院时的m RS评分分为预后不良组58例,预后良好组236例;预后不良组的首次美国国立卫生院脑卒中量表(NIHSS)评分、首次CQSS评分、CQSS评分增幅均高于预后良好组,且首次CQSS评分和NIHSS评分之间存在显著的相关性(Pearson系数=0.914,P<0.001)。CQSS对LS患者在出院时存在不良预后的风险具有较好的预测意义(AUC=0.760,95%CI 0.692-0.829,P<0.001),截断值为5分。CQSS评分对于出现END事件的预测准确度较低(AUC=0.613,95%CI 0.538-0.689,P=0.007)。结论:CQSS评分对LS患者短期不良结局发生风险预测价值较高,评分越高出现不良预后的风险越大,对于发生END的风险预测价值一般,需要进一步研究探讨以提高对END事件的预测效能。Objective:We assessed the efficacy of the Chongqing Stroke Scale(CQSS)for predicting poor short-term outcome and early neurological deterioration(END)in patients with lacunar stroke.Methods:We prospectively enrolled 294 LS patients hospitalized in the Neurology Department of Aerospace Center Hospital from June 2020 to May 2021.Related baseline data were recorded and patients were evaluated by the CQSS.The main outcome events were defined as poor functional outcome at discharge[modified Rankin scale(mRS)≥3 points].The secondary outcome events were defined as END.The efficacy of the CQSS in predicting outcome events was quantified by the area under the Receiver Operating Characteristic curve(AUC).Results:The number of patients with poor prognosis and with good prognosis patients,according to the mRS scores at discharge,was 58 and 236,respectively.The initial NIHSS score,initial CQSS score,and increase of CQSS score in the poor prognosis group were higher than those in the good prognosis group,and there was a significant correlation between the initial CQSS score and NIHSS score(Pearson coefficient=0.914,P<0.001).CQSS had good predictive value for the risk of poor prognosis in LS patients at discharge(AUC=0.760,95%CI:0.692-0.829,P<0.001),with a cut-off value of 5 points.CQSS was less accurate in predicting END events(AUC=0.613,95%CI:0.538-0.689,P=0.007).Conclusion:The CQSS score has good predictive value for the risk of short-term adverse outcomes in LS patients,with a higher score indicating a greater risk of poor prognosis.Predictive value of CQSS for the risk of END is moderate,and further research is needed to improve this aspect.

关 键 词：腔隙性卒中 早期神经功能缺损进展 预后 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] R743[医药卫生—临床医学]