改良CT-DRAGON评分对急性缺血性卒中血管内治疗后预后的预测价值  

Predictive value of Modified CT-DRAGON score for outcome after endovascular treatment in patients with acuteischemic stroke

作　　者：刘景明 王尚静 王同兴[2] 任军[2] 陈国中 谷贺 LIU Jingming;WANG Shangjing;WANG Tongxing(Department of Emergency,Xuzhou Tumor Hospital,Xuzhou 221005,China)

机构地区：[1]徐州市肿瘤医院急诊科,221005 [2]南京医科大学附属南京医院(南京市第一医院)医学影像科

出　　处：《临床神经病学杂志》2023年第5期331-336,共6页Journal of Clinical Neurology

基　　金：国家自然科学基金(82001811)。

摘　　要：目的 探讨改良CT-DRAGON评分对急性缺血性脑卒中血管内治疗后预后的预测价值。方法 选取2017年1月至2021年12月在徐州市肿瘤医院接受血管内治疗的急性缺血性脑卒中患者74例。于治疗前采用CT-DRAGON评分和改良CT-DRAGON评分进行评价,3个月时采用mRS量表评价预后并分为预后良好组和预后不良组。应用ROC曲线分析CT-DRAGON评分和改良CT-DRAGON评分对预后的预测价值,并采用Delong检验比较二者差异。结果 与预后良好组相比,预后不良组CT-DRAGON评分(z=2.341,P=0.009)、改良CT-DRAGON评分(z=-5.341,P <0.001)显著升高。Logistic回归分析显示,改良CT-DRAGON评分预测卒中不良预后的C-statistic(C-statistic=0.85,95%CI:0.77~0.88)明显高于CT-DRAGON评分的Cstatistic(C-statistic=0.77,95%CI:0.66~0.80)。ROC曲线显示改良CT-DRAGON评分预测卒中预后的曲线下面积明显高于CT-DRAGON评分(0.885 vs. 0.743;Z=-2.176,P=0.030),其敏感度和特异度达0.882、0.700。结论 与传统CT-DRAGON评分比较,改良CT-DRAGON评分可更有效预测急性缺血性卒中患者血管内治疗后3个月预后。Objective To investigate the predictive value of CT-DRAGON score for outcome after endovascular treatment in patients with acute ischemic stroke. Methods Seventy-four patients with acute ischemic stroke underwent endovascular treatment in Xuzhou Tumor Hospital from January 2017 to December 2021 were included retrospectively. Modified CT-DRAGON and CT-DRAGON score were performed before treatment,respectively. The outcome at 3 month was evaluated with the mRS at 3 months after treatment. And the patients were divided into good outcome group and poor outcome group. The ROC curve was used to analyze the predictive value of modified CTDRAGON and CT-DRAGON score for outcome,and the difference was compared by Delong test. Results Compared with the good outcome group,the CT-DRAGON score(z = 2. 341,P = 0. 009)and modified CT-DRAGON score(z =-5. 341,P<0. 001)in poor outcome group were significantly increased. Logstic regression analysis showed that the C-statistic of modified CT-DRAGON score(C-statistic = 0. 85,95% CI:0. 77-0. 88)was significantly higher than that of CT-DRAGON score(C-statistic = 0. 77,95% CI:0. 66-0. 80)in predicting poor outcome of stroke. ROC curve showed that the area under the curve of modified CT-DRAGON score was significantly higher than that of CT-DRAGON score in predicting poor outcome of stroke(0. 885 vs. 0. 743;Z =-2. 176,P = 0. 030),and its sensitivity and specificity reached 0. 882 and 0. 700,respectively. Conclusion Comparing with the traditional CT-DRAGON score,the modified CT-DRAGON score can more effectively predict the clinical outcome of patients with acute ischemic stroke at 3 months after endovascular treatment.

关 键 词：卒中 血管内治疗 CT-DRAGON评分 预后 预测价值 

分 类 号：R743.3[医药卫生—神经病学与精神病学]