ASTRAL量表评分对后循环急性脑梗死患者预后的评估价值

发布时间：2018-02-26 09:04

  本文关键词： 脑梗死 椎基底动脉供血不足 ASTRAL量表评分 预后 评估　出处：《中国全科医学》2016年09期 　论文类型：期刊论文

【摘要】：目的探讨ASTRAL量表评分对后循环急性脑梗死(ACI)患者预后的评估价值。方法选择2011年6月—2014年6月于华北理工大学附属医院神经内科住院的经颅脑MRI明确诊断的后循环ACI患者211例为研究对象。患者在入院24 h内采用ASTRAL量表进行评分,发病30 d时采用改良Rankin量表(mRS)评分进行预后评估。按照mRS评分将患者分为预后良好组和预后不良组。描绘ASTRAL量表评分评估后循环ACI患者预后的受试者工作特征曲线(ROC曲线),计算ROC曲线下面积(AUC)、最大Youden指数,找出理想界值;以预后为因变量,ASTRAL量表评分为自变量,进行Fisher法线性判别分析。结果预后良好组167例,预后不良组44例。预后良好组患者ASTRAL量表评分低于预后不良组(t=-7.66,P0.05)。预后不良率随ASTRAL量表评分增加而升高(P0.05)。ASTRAL量表评分评估后循环ACI患者预后的AUC为0.788,95%CI(0.712,0.864),理想界值为19分,灵敏度为72.7%,特异度为68.9%,正确率为69.7%。按照理想界值将患者分为高分组(≥19分,84例)和低分组(19分,127例)。高分组患者预后不良率高于低分组(χ~2=25.14,P0.01)。Fisher法线性判别分析得到判别方程式:Y_0=-6.807+0.709X,Y_1=-12.191+0.972X,其中Y_0为预后良好,Y_1为预后不良。用该判别方程式对患者预后进行判别,正确率为71.8%,进一步行Bayes交互验证,计算准确度为71.7%,提示该判别方程式有较好的稳定性。结论 ASTRAL量表评分对后循环ACI患者预后有一定的评估价值。
[Abstract]:Objective to evaluate the prognostic value of ASTRAL scale score in patients with posterior circulation acute cerebral infarction (ACI). Methods from June 2011 to June 2014, the patients hospitalized in the Department of Neurology, affiliated Hospital of North China University of Technology, were selected for the definite diagnosis of craniocerebral MRI. Two hundred and eleven patients with annular ACI were assessed with ASTRAL scale within 24 hours of admission. The patients were divided into good prognosis group and poor prognosis group according to the modified Rankin scale mRS score 30 days after the onset of the disease. The operating characteristic curve of the patients with circulatory ACI was described in the evaluation of the prognosis of the patients with circulatory ACI by the ASTRAL scale score. The area under the ROC curve is calculated, and the maximum Youden exponent is obtained. To find out the ideal bound value, to use the prognosis as the dependent variable and the score of the ASTURL scale as the independent variable, to carry out linear discriminant analysis with Fisher method, the results showed that the prognosis was good in the group of 167 cases. 44 cases of poor prognosis group. The score of ASTRAL scale in the group of good prognosis was lower than that in the group of poor prognosis (P 0.05). The rate of poor prognosis increased with the increase of ASTRAL score. The AUC of the patients with circulating ACI was 0.788% 95% CIQ 0.7120.864, and the ideal score was 19 points. The sensitivity was 72.7, the specificity was 68.9 and the correct rate was 69.7.The patients were divided into high score group (84 cases 鈮，

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