急性缺血性脑卒中静脉溶栓预后不良预警模型构建
Construction of warning model for bleak prognosis of acute ischemic stroke treated with intravenous thrombolysis
林志超 1潘思金 1谢玉龙 1黄立安2
作者信息
- 1. 暨南大学附属第一医院影像中心,广东广州 510630
- 2. 暨南大学附属第一医院神经内科,广东广州 510630
- 折叠
摘要
目的:对急性缺血性脑卒中(AIS)静脉溶栓的预后不良影响因素进行分析,构建其不良预警模型为其并发症防治提供依据.方法:收集256例AIS患者,4.5 h内均行静脉溶栓及用药后1h内进行DWI检查,治疗3个月后按MRS评分结果分为82例预后不良组(>2分)和174例预后良好组(≤2分,采用Logistic回归分析预后不良影响因素,构建其预警模型及使用ROC曲线分析模型预测效能.结果:低DWI-ASPECTS和高NIHSS评分均是预后不良的危险因素(P= 0.01).ROC曲线显示,当NIHSS≥5分、DWI-ASPECTS<8分、NIHSS≥5分且DWI-ASPECTS<8分时,对静脉溶栓预后不良预测灵敏度、特异度、阳性率及阴性率分别为92%、47%、45%、92%,79%、80%、65%、89%,93%、73%、69%、94%,差别有统计学意义(P<0.01).结论:AIS静脉溶栓预后不良危险因素是高基线NIHSS评分和低基线DWI-ASPECTS评分,联合构建其预后不良预警模型有助于防治静脉溶栓后并发症.
Abstract
Objective To analyze the adverse prognostic factors for acute ischemic stroke(AIS)treated with intravenous thrombolysis,and construct a warning model to provide a basis for the prevention and treatment of complications.Methods A total of 256 AIS patients were collected and treated with intravenous thrombolysis within 4.5 h after cerebral hemorrhage and underwent DWI examination within 1 h after medication.Three months after treatment,they were divided into poor prognosis group(n=82,MRS score>2)and good prognosis group(n=174,MRS score≤2).Logistic regression analysis was used to analyze the adverse prognostic factors for constructing the warning model whose predictive efficacy was evaluated with ROC curve.Results Low DWI-ASPECTS and high NIHSS score were both risk factors for poor prognosis(P=0.01).The ROC curve analysis showed that for predicting poor prognosis,the model had sensitivity,specificity,positive and negative rates of 92%,47%,45%,92%in NIHSS score≥5,79%,80%,65%,89%in DWI-ASPECTS score<8,and 93%,73%,69%,94%in NIHSS score≥5 and DWI-ASPECTS score<8,with significant differences(P<0.01).Conclusion High baseline NIHSS score and low baseline DWI-ASPECTS score are the risk factors for poor prognosis in AIS,and the combined construction of a warning model is helpful to prevent and treat complications after intravenous thrombolysis.
关键词
急性缺血性脑卒中/静脉溶栓/NIHSS/DWI-ASPECTS/预警模型Key words
acute ischemic stroke/intravenous thrombolysis/NIHSS/DWI-ASPECTS/warning model引用本文复制引用
基金项目
国家自然科学基金(81971120)
高等学校人文社会科学重点研究基地重大项目(16JJD190003)
广州市天河区科技计划卫生重点项目(2018YZ003)
暨南大学附属第一医院教学改革项目(SPJG202301)
出版年
2024
NETL
NSTL
维普
万方数据