5种评分系统对不同时间窗急性脑梗死静脉溶栓后出血转化风险预测差异的比较研究

发布时间：2018-07-12 09:47

  本文选题：急性脑梗死 + 静脉溶栓　； 参考：《第三军医大学学报》2017年17期

【摘要】：目的比较5种评分系统对不同时间窗的急性脑梗死静脉溶栓后出血转化(hemorrhagic transformation,HT)风险的预测价值。方法对2014年1月至2016年12月对不同时间窗内仅接受重组组织型纤溶酶原激活物(recombinant tissue-type plasminogen activator,rt-PA)静脉溶栓的243例急性脑梗死患者进行单中心、回顾性研究。应用HAT评分、GRASPS评分、SEDAN评分、MSS评分及SITS评分量表进行测评,观察5种评分系统与不同时间窗内的急性脑梗死接受静脉溶栓后出现HT的关系;应用ROC曲线下面积大小比较5种评分系统在不同时间窗静脉溶栓后出HT的预测能力。结果针对不同时间窗,比较5种评分系统ROC曲线下面积,结果显示:≤3 h时GRASPS及HAT评分系统的ROC曲线下面积(分别为0.698、0.619)高于其他评分系统;3~4.5 h时,SEDAN评分、HAT评分(ROC面积分别为0.744,0.719)优于其他评分系统(P0.05);4.5~6 h时,HAT评分系统(ROC曲线下面积为0.676)优于其他评分系统。结论 5种评分系统对所有时间窗静脉溶栓后HT的发生有较好的预测能力。在不同时间窗,特别是在4.5 h内,HAT评分系统对HT风险预测可能拥有相对较好的预测价值。
[Abstract]:Objective to compare the predictive value of five scoring systems for hemorrhagic transformation HT in acute cerebral infarction with different time windows. Methods from January 2014 to December 2016, a single center study was performed in 243 patients with acute cerebral infarction who received only recombinant tissue plasminogen activator (recombinant tissue-type plasminogen activator rt-PA) in different time windows. To evaluate the effects of different time windows on HT in patients with acute cerebral infarction after intravenous thrombolytic therapy, the patients were evaluated with hat score, grass ASPS score, SEDAN score, MSS score and site score scale. The results were as follows: (1) the relationship between the five scoring systems and the occurrence of HT in acute cerebral infarction after intravenous thrombolytic therapy was observed. The area size under the ROC curve was used to compare the predictive ability of 5 scoring systems for HT after intravenous thrombolysis at different time windows. Results according to different time windows, the area under ROC curve of five scoring systems was compared. The results showed that the area under the ROC curve of GrASPS and hat scoring system at 鈮，

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