| 罗剑木,曹奔.DWI-ASPECTS评分在静脉溶栓治疗急性脑梗死患者预后评估中的价值.[J].中南医学科学杂志.,2022,(1):113-116. |
| DWI-ASPECTS评分在静脉溶栓治疗急性脑梗死患者预后评估中的价值 |
| The value of DWI-ASPECTS score in the evaluation of prognosis of patients with acute cerebral infarction treated by intravenous thrombolysis |
| 投稿时间：2021-01-28 修订日期：2021-02-25 |
| DOI：10.15972/j.cnki.43-1509/r.2022.01.027 |
| 中文关键词: Alberta卒中项目早期CT评分 急性脑梗死 静脉溶栓 弥散加权成像 预后评估 |
| 英文关键词:Alberta stroke program early CT score acute cerebral infarction intravenous thrombolysis diffusion weighted imaging prognosis evaluation |
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| 中文摘要: |
| 目的探讨基于弥散加权成像的Alberta卒中项目早期CT评分(DWI-ASPECTS)在静脉溶栓治疗急性脑梗死患者预后评估中的价值。 方法选取88例急性脑梗死患者,静脉溶栓治疗3个月后,根据改良Rankin量表(mRS)评分结果分为良好转归组(0～2分,58例)和不良转归组(3～6分,30例)。溶栓治疗24 h内行MRI检查,记录ASPECTS评分,比较两组患者临床资料和影像学资料。急性脑梗死患者预后的影响因素分析采用Logistic回归分析,用受试者工作曲线(ROC)分析独立影响因素对预后的预测价值,记录曲线下面积(AUC)。 结果与不良转归组比较,良好转归组患者年龄较小,入院NIHSS评分较低,DWI-ASPECTS评分较高(P＜0.05)。Logistic回归分析显示,年龄、DWI-ASPECTS评分、入院NIHSS评分均为不良转归发生的独立预测因素(P＜0.05)；ROC曲线结果显示,DWI-ASPECTS评分预测不良转归的最佳临界值为5分,灵敏度为73.33%,特异度为89.66%,AUC值为0.897,AUC明显高于年龄、入院NIHSS评分预测不良转归的AUC值(P＜0.05)。 结论DWI-ASPECTS评分对急性脑梗死患者溶栓治疗后的预后转归有较高的预测价值,年龄、入院NIHSS评分、DWI-ASPECTS评分均为不良转归发生的影响因素。 |
| 英文摘要: |
| To evaluate the value of DWI-ASPECTS in the prognosis of patients with acute cerebral infarction after intravenous thrombolysis. Methods88 patients with acute cerebral infarction were selected and divided into good outcome group (0－2 points, 58 cases) and bad outcome group (3－6 points, 30 cases) according to the modified Rankin Scale (mRS) score after intravenous thrombolysis for 3 months. MRI was performed within 24 hours after thrombolytic therapy, and ASPECTS score was recorded. The clinical and imaging data of the two groups were compared. Logistic regression analysis was used to analyze the prognostic factors of patients with acute cerebral infarction. Receiver operating curve (ROC) was used to analyze the predictive value of independent factors for prognosis, and area under curve (AUC) was recorded. ResultsCompared with the poor outcome group, the good outcome group had younger age, lower NIHSS score and higher DWI-ASPECTS score (P＜0.05). Logistic regression analysis showed that age, NIHSS score and DWI-ASPECTS score were independent predictors of adverse outcomes (P＜0.05); ROC curve results showed that the best critical point of DWI-ASPECTS score in predicting adverse outcome was 5 points, the sensitivity was 73.33%, the specificity was 89.66%, and the AUC value was 0.897, which was significantly higher than that of age and NIHSS score in predicting adverse outcome (P＜0.05). ConclusionDWI-ASPECTS score has a high predictive value for the prognosis of patients with acute cerebral infarction after thrombolytic therapy. Age, NIHSS score and DWI-ASPECTS score are the influencing factors of adverse outcomes. |
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