MR血栓负荷评分联合FVH对急性缺血性卒中双抗治疗的预测价值  

Value of MR clot burden score combined with FVH in predicting the prognosis of acute ischemic stroke with the dual antiplatelet therapy

作　　者：史孟容 胡子涛 雷格格 马莹莹 李延静[1] 秦江彦 SHI Meng-rong;HU Zi-tao;LEI Ge-ge;MA Ying-ying;LI Yan-jing;QIN Jiang-yan(Department of Imaging,Affiliated Hospital of Yan'an University,Yan'an Shaanxi 716000,China)

机构地区：[1]延安大学附属医院影像科,陕西延安716000

出　　处：《中国临床医学影像杂志》2025年第1期6-10,共5页Journal of China Clinic Medical Imaging

摘　　要：目的:旨在探讨MR血栓负荷评分(CBS)联合液体衰减反转恢复血管高信号(FVH)对超溶栓时间窗接受双联抗血小板治疗(DAPT)的急性缺血性卒中(AIS)患者预后的预测价值。方法:收集发病6~72 h内接受DAPT的AIS患者111例进行回顾性分析。根据3月后改良Rankin量表(mRS),分为预后良好(mRS≤2)组和预后不良(mRS>2)组。比较两组患者基线资料差异,并采用单因素和多因素Logistic回归筛选预后不良的独立影响因素。基于以上结果建立预测模型,模型的校准度评价采用Hosmer-Lemeshow拟合优度检验,并绘制ROC曲线分析各模型预测效能。结果:多因素Logistic回归分析表明,基线NIHSS评分、NLR、FVH-ASPECTS评分及CBS是AIS患者3月后预后不良的独立影响因素。CBS+FVH联合预测模型HosmerLemeshow拟合优度检验χ^(2)=4.343,P=0.825;AUC为0.956(95%CI 0.924~0.988)。结论:对于超溶栓时间窗接受DAPT的AIS患者,基线NIHSS评分、NLR、FVH-ASPECTS评分及CBS是预后不良的独立影响因素。CBS+FVH联合预测模型有较高的预测效能,可为DAPT治疗的AIS患者预后评估提供一定临床价值。Objective:To explore the value of MR clot burden score(CBS)combined with FVH in predicting the prognosis of acute ischemic stroke(AIS)who received dual antiplatelet therapy(DAPT)over the time window of thrombolysis.Methods:A retrospective analysis was conducted on 111 patients with AIS who received DAPT within 6 to 72 hours of onset.According to the modified rankin scale(mRS)score after 3 months,they were divided into good prognosis(mRS≤2)group and poor prognosis(mRS>2)group.The differences of baseline data between the two groups were compared,and univariate and multivariate Logistic regression were used to screen the independent influencing factors of poor prognosis.Based on the above results,prediction model was established,the calibration degree of the model was evaluated by Hosmer-Lemeshow goodness-of-fit test,and the ROC curve was drawn to analyze the predictive efficiency of each model.Results:Multivariate Logistic regression analysis showed that baseline NIHSS score,NLR,FVH-ASPECTS score and CBS were independent influencing factors of poor prognosis after 3 months in AIS patients.The Hosmer-Lemeshow goodness of fit test of CBS+FVH combined prediction model was χ^(2)=4.343,P=0.825.The AUC was 0.956(95%CI 0.924~0.988).Conclusion:For patients with AIS who received DAPT over the thrombolysis time window,baseline NIHSS score,NLR,FVH-ASPECTS score and CBS are independent risk factors for poor prognosis.CBS+FVH combined predictive model has high predictive efficiency and can provide a certain clinical value for evaluating the prognosis of AIS patients treated with DAPT.

关 键 词：缺血性卒中 磁共振成像 

分 类 号：R743.31[医药卫生—神经病学与精神病学] R445.2[医药卫生—临床医学]