基于ROSIER评分量表筛查急诊脑卒中高危人群效果及其危险因素暴露情况  

Screening effect and risk factor exposure of emergency cerebral infarction high-risk population based on ROSIER score scale

作　　者：黄芳 汪宁[1] 康梅娟[1] 刘义锋[1] 孙军[1] 王洁[1] HUANG Fang;WANG Ning;KANG Mei-juan;LIU Yi-feng;SUN Jun;WANG Jie(Department of Neurointervention,Nanyang Central Hospital,Nanyang,Henan 473000,China)

机构地区：[1]南阳市中心医院神经介入科,河南南阳473000

出　　处：《医药论坛杂志》2023年第17期27-31,共5页Journal of Medical Forum

基　　金：河南省医学科技攻关计划项目(192102310349)。

摘　　要：目的 探讨急诊脑卒中识别评分量表(ROSIER)与面、臂、言语、时间评分量表(FAST)筛查脑卒中(CI)的应用价值,并分析高危人群危险因素暴露情况。方法 选取2020年1月—2022年7月南阳市中心医院收治的疑似CI患者207例为研究对象,采用ROSIER、FAST分别对疑似CI患者进行评估。以综合诊断结果为金标准,对比分析两种量表筛查CI的价值。基于ROSIER筛查CI患者高危人群,并分析其危险因素暴露情况。结果 207例疑似CI患者中,确诊为CI 140例、非CI 67例;FAST诊断CI的敏感度、特异度、准确度分别为83.57%、73.13%、80.19%;ROSIER诊断CI的敏感度、特异度、准确度分别为92.86%、80.60%、88.89%;不同年龄、性别、文化程度、居住地、婚姻状况、事业、吸烟史、缺乏运动、脑卒中家族史、高血压、糖尿病、房颤、血脂异常、超重患者高危人群检出率比较差异有统计学意义(P<0.05);基于ROSIER检出的CI高危人群中超重、高血压、糖尿病、缺乏运动、血脂异常5个方面危险因素处于较高暴露水平;logistic回归分析显示与CI高危人群关联性较高的危险因素依次分别为超重、高血压、糖尿病、缺乏运动、脑卒中家族史、血脂异常、年龄、吸烟史(P<0.05)。结论 ROSIER评分量表对早期识别CI具有临床应用价值,基于ROSIER评分量表筛查CI高危人群中危险因素暴露水平较高,控制危险因素水平,有助于降低CI发生风险。Objective To investigate the application value of emergency Stroke Recognition Scale(ROSIER)and Face,Arm,Speech and Time Scale(FAST)in screening for cerebral infarction(CI),and to analyze the exposure of risk factors in high-risk population.Methods Totally 207 suspected CI patients admitted to our hospital from January 2020 to July 2022 were selected as research objects.ROSIER and FAST were used to evaluate suspected CI patients respectively.The value of CI screening of the two scales was compared and analyzed with the comprehensive diagnosis results as the gold standard.ROSIER was used to screen high-risk groups of CI patients and analyze their exposure to risk factors.Results Among 207 suspected patients with CI,140 cases were confirmed as CI and 67 cases were not CI.The sensitivity,specificity and accuracy of FAST diagnosis of CI were 83.57%,73.13%and 80.19%,respectively.The sensitivity,specificity and accuracy of ROSIER in diagnosing CI were 92.86%,80.60%and 88.89%,respectively.Different age,sex,education,residence,marital status,career,smoking history,lack of exercise,family history of stroke,hypertension,diabetes,atrial fibrillation,dyslipidemia,overweight patients with high risk of detection rates were statistically significant differences(P<0.05);In CI high-risk groups detected by ROSIER,overweight,hypertension,diabetes,lack of exercise and dyslipidemia were at high exposure levels.logistic regression analysis showed that the risk factors with high association with CI high-risk group were overweight,hypertension,diabetes,lack of exercise,family history of stroke,dyslipidemia,age and smoking history(P<0.05).Conclusion ROSIER score scale has clinical application value for early identification of CI.Screening high risk factor exposure level in high risk groups of CI based on ROSIER score scale and controlling risk factor levelare helpful to reduce the risk of CI.

关 键 词：脑卒中 急诊脑卒中识别评分量表 筛查 高危人群 危险因素 暴露率 

分 类 号：R743.3[医药卫生—神经病学与精神病学]