基于颈动脉高分辨磁共振成像的改良脑卒中风险评分模型对脑卒中患者再发风险的预测研究

发布时间：2018-06-26 04:18

  本文选题：缺血性脑卒中 + 再发性脑卒中　； 参考：《临床放射学杂志》2017年06期

【摘要】：目的在Essen卒中风险评分量表(ESRS)模型基础上,结合颈动脉高分辨MR成像技术,建立改良脑卒中风险评分模型(RSRS)。方法回顾性分析41例缺血性脑卒中(AIS)初发和再发患者的临床及实验室指标,所有患者均行高分辨MR序列成像,对比初发及再发AIS患者颈动脉斑块负荷和成分的差别,并进行Logstic多因素回归分析,筛选出独立危险因素并逐步构建分层方案,联合ESRS形成改良的RSRS,利用ROC曲线评估ESRS及RSRS预测卒中再发的准确性。结果 (1)再发组与初发组AIS患者高血压、糖尿病、低密度脂蛋白(LDL-C)、总胆固醇(TC)、标准化管壁指数(NWI)、斑块内出血(IPH)比例、破裂的纤维帽(FCR)比例、富含脂质坏死核心(LRNC)最大面积/指数和IPH最大面积/指数组间差异均有统计学意义(P0.05)。(2)LDL-C、IPH、FCR、NWI值及LRNC指数是AIS患者发生再发脑卒中的独立危险因素。(3)ROC曲线显示,ESRS及RSRS评分的曲线下面积分别为0.890和0.912,当RSRS评分=6分时,其敏感性及特异性最高。结论 ESRS和RSRS均对AIS再发有明确的预测价值,但改良后的RSRS预测价值更大;RSRS评分=6分可作为预测AIS再发风险的分层方案。
[Abstract]:Objective to establish a modified stroke risk scale (RSRS) based on Essen Stroke risk scale (ESRS) and carotid high resolution Mr imaging. Methods the clinical and laboratory indexes of 41 patients with ischemic stroke (AIS) were analyzed retrospectively. All patients underwent high resolution Mr sequence imaging. The carotid plaque load and composition were compared between primary and recurrent AIS patients. Logistic multivariate regression analysis was performed to screen out independent risk factors and gradually construct a stratified scheme to form improved RSRSs combined with ESRS. The accuracy of ESRS and RSRS in predicting stroke recurrence was evaluated by ROC curve. Results (1) Hypertension, diabetes, low density lipoprotein (LDL-C), total cholesterol (TC), standardized wall index (NWI), intraplaque hemorrhage (IPH), broken fibrous cap (FCR) were observed in recurrent and primary AIS patients. There were significant differences in the maximum area / index and the maximum area / index of lipid necrosis core (LRNC) between the two groups (P0.05). (P0.05) LDL-CMr FCR-NWI value and LRNC index were independent risk factors for recurrent stroke in AIS patients. (3) the ROC curve showed the ESRS and RSRS scores. The area under the curve was 0.890 and 0.912, respectively, when the RSRS score was 6, Its sensitivity and specificity are the highest. Conclusion both ESRS and RSRS have definite predictive value for AIS recurrence, but the improved RSRS score of 6 can be used to predict the recurrence risk of AIS.
【作者单位】： 福建医科大学附属第一医院影像科;福建卫生职业技术学院附属省直机关医院医学影像科;
【基金】：福建省卫生系统中青年骨干人才培养项目(编号:2013-ZQN-JC-12)
【分类号】：R743.3

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