颈动脉斑块性质、颅内动脉狭窄程度联合ESRS评分对脑梗死复发的预测价值  

The predictive value of carotid plaque nature,intracranial arterial stenosis degree and Essen stroke risk scale for cerebral infarction recurrence

作　　者：杨李霞 蒋天安[2] 张丽 何金峰[3] YANG LIxia;JIANG Tianan;ZHANG Li;HE Jinfeng(Department of Ultrasound,Taizhou Municipal Hospital,Taizhou 318000,Zhejiang,China;Department of Ultrasound Medicine,the First Affiliated Hospital of Zhejiang University Medical College,Hangzhou 310003,Zhejiang,China;Department of Neurology,Taizhou Municipal Hospital,Taizhou 318000,Zhejiang,China)

机构地区：[1]台州市立医院超声医学科,浙江台州318000 [2]浙江大学医学院附属第一医院超声医学科,浙江杭州310003 [3]台州市立医院神经内科,浙江台州318000

出　　处：《中国现代医生》2023年第3期46-50,共5页China Modern Doctor

摘　　要：目的探讨颈动脉斑块性质、颅内动脉狭窄程度联合Essen卒中风险评分量表(Essen stroke risk score,ESRS)对脑梗死复发的预测价值。方法采用ESRS评分对120例初发脑梗死患者进行危险度分层,分析不同危险层次的脑梗死患者1年内的复发率,分别探讨颈动脉斑块软斑组、混合斑块组、硬斑组及颅内动脉不同程度狭窄组与脑梗死复发的关系,并分析颈动脉斑块性质、颅内动脉狭窄程度与ESRS分层模型对脑梗死1年内复发的预测能力及三者联合预测脑梗死1年内复发风险的能力。结果脑梗死患者颈动脉斑块软斑组及混合斑块组1年内复发率显著高于无斑块或硬斑组(P<0.001);脑梗死重度狭窄组及闭塞组1年内复发率显著高于正常或轻度狭窄组(P<0.05)。ESRS分层低危、高危两组间比较,差异有统计学意义(P<0.05),高危组1年内脑梗死复发的风险高于低危组。颈动脉斑块性质、颅内动脉狭窄程度、ESRS分层模型及三者联合预测脑梗死1年内复发的受试者操作特征曲线(receiver operating characteristic curve,ROC曲线)下面积分别为0.791、0.789、0.648、0.871,三者联合面积最大。结论颈动脉斑块性质、颅内动脉狭窄程度联合ESRS评分对预测脑梗死患者1年内复发的风险具有较高价值。Objective To investigate the predictive value of carotid plaque nature,intracranial artery stenosis degree and Essen stroke risk score scale(ESRS)for cerebral infarction recurrence.Methods ESRS score was used to stratify the risk of 120 patients with initial cerebral infarction and analyze the recurrence rate of patients with different risk levels of cerebral infarction within 1 year.the relationship between carotid plaque soft plaque group,mixed plaque group,hard plaque group and different degrees of intracranial artery stenosis group and cerebral infarction recurrence were explored.The prediction ability of carotid plaque nature,intracranial artery stenosis degree and ESRS stratified model for recurrence of cerebral infarction within 1 year was analyzed,as well as the ability of the three models combinedto predict the risk of cerebral infarction recurrence.Results The one-year recurrence rate of cerebral infarction patients in carotid plaque soft plaque group and mixed plaque group was significantly higher than that in no plaque or hard plaque group(P<0.001).The one-year recurrence rate of severe stenosis and occlusion group was significantly higher than that of normal or mild stenosis group(P<0.05).There was statistical difference between low risk and high risk groups in ESRS stratification.The risk of recurrence of cerebral infarction within 1 year in high-risk group was higher than that in low-risk group.The area under ROC curve of carotid plaque nature,intracranial artery stenosis degree,ESRS stratification model and their combined stratification for predicting recurrence of cerebral infarction within 1 year were 0.791,0.789,0.648 and 0.871,respectively.The area of combined the three was the largest.Conclusion Thecarotid plaque natureand the degree of intracranial artery stenosis combined with ESRS score have high value in predicting the risk of recurrence in patients with cerebral infarction within 1 year.

关 键 词：脑梗死 复发 颈动脉斑块性质 颅内动脉狭窄程度 ESRS评分 预测 

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