全科医学临床与教育2024，Vol.22Issue(2) ：123-127.DOI:10.13558/j.cnki.issn1672-3686.2024.002.007

脑小血管病总负荷评分联合磁敏感加权血管造影预测急性腔隙性脑梗死卒中复发的临床价值

Clinical value of total cerebral small vessel disease load score combined with susceptibility-weighted angiogra-phy in predicting stroke recurrence in acute lacunar cerebral infarction

王辉 王静 汪兰
全科医学临床与教育2024，Vol.22Issue(2) ：123-127.DOI:10.13558/j.cnki.issn1672-3686.2024.002.007
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  • 万方数据

脑小血管病总负荷评分联合磁敏感加权血管造影预测急性腔隙性脑梗死卒中复发的临床价值

Clinical value of total cerebral small vessel disease load score combined with susceptibility-weighted angiogra-phy in predicting stroke recurrence in acute lacunar cerebral infarction

王辉 1王静 2汪兰3
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作者信息

  • 1. 314200 浙江平湖,平湖市第一人民医院放射科
  • 2. 宣城市中心医院放射科
  • 3. 浙江衢化医院放射科
  • 折叠

摘要

目的 探讨脑小血管病(CSVD)总负荷评分联合磁敏感加权血管造影(SWAN)预测急性腔隙性脑梗死卒中复发的临床价值.方法 选取 88 例首次发病的急性腔隙性脑梗死患者临床资料,随访3 个月,无失访病例,将31 例脑卒中复发的患者设为观察组,57 例脑卒中未复发的患者设为对照组.所有患者入院后行头部核磁共振(MRI)检查和SWAN检查,评估CSVD总负荷评分与SWAN检查的不对称性皮质静脉征(ACVS)情况,并收集两组相关临床资料,利用多因素logistic回归分析急性腔隙性脑梗死卒中复发的危险因素,并采用受试者工作特征曲线(ROC)评价分析CSVD总负荷评分、SWAN检查对急性腔隙性脑梗死卒中复发的预测价值.结果 经多因素logis-tic回归分析结果显示,美国国立卫生院卒中表量(NIHSS)评分高、CSVD总负荷评分≥3 分、ACVS阳性是急性腔隙性脑梗死卒中复发的危险因素(OR分别=1.24、1.87、2.12,P均＜0.05).ROC曲线结果显示CSVD总负荷评分、SWAN检查两者单项与两者联合预测急性腔隙性脑梗死卒中复发的AUC分别为0.71、0.79、0.85,灵敏度分别为71.00%、83.90%、93.50%,特异度分别为71.90%、73.70%、74.70%.结论 急性腔隙性脑梗死卒中复发与入院时NIHSS评分高、CSVD总负荷评分≥3 分、ACVS阳性有关,CSVD总负荷评分联合SWAN检查在急性腔隙性脑梗死卒中复发中具有较高的预测价值,为临床早期预防措施提供有力指导.

Abstract

Objective To evaluate the clinical value of total cerebral small vessel disease(CSVD)load score com-bined with susceptibility-weighted angiography(SWAN)in predicting stroke recurrence in acute lacunar cerebral infarc-tion.Methods Clinical data of 88 patients with first onset acute lacunar cerebral infarction were selected,and all sub-jects completed a 3-month following-up.Patients with stroke recurrence were included into observation group,and those without recurrence were set as control group.All patients performed magnetic resonance imaging(MRI)and SWAN.Then the total CSVD load score and the asymmetric cortical vein sign(ACVS)on susceptibility-weighted angiography were evaluated.Multivariate logistic regression analysis was performed to identify the risk factors of stroke recurrence in acute lacunar cerebral infarction,and predictive value of total CSVD load score and SWAN examination for stroke recurrence in acute lacunar cerebral infarction was tested by receiver operating characteristic curve(ROC).Results Multivariate logistic regression analysis denoted that national institutes of higher health stroke scale(NIHSS)score,total CSVD load score≥3 and ACVS positive were risk factors for stroke recurrence following acute lacunar cerebral infarction(OR=1.24,1.87,2.12,P＜0.05).Areas under the curve(AUC)for the separate and combined tests of total CSVD load score and SWAN examination in predicting stroke recurrence following acute lacunar cerebral infarction were 0.71,0.79,and 0.85,with a sensitivity of 71.00%,83.90%,and 93.50%and specificity of 71.90%,73.70%,and 74.70%,respectively.Conclu-sion Stroke recurrence following acute lacunar ce-rebral infarction is associated with higher NIHSS score,total CSVD load score≥3,and positive ACVS.Total CSVD load score combined with SWAN exami-nation has high predictive value,which provides a guide for development of clinical early preventive measures.

关键词

脑小血管病总负荷评分/磁敏感加权血管造影/急性腔隙性脑梗死卒中/复发/预测价值

Key words

total cerebral small vessel disease load score/susceptibility-weighted angiography/acute lacunar ce-rebral infarction/recurrence/predictive value

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出版年

2024
全科医学临床与教育
浙江大学

全科医学临床与教育

影响因子：0.63
ISSN：1672-3686
参考文献量23
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