SPAN-100评分联合炎性标志物预测缺血性脑卒中静脉溶栓后症状性颅内出血的风险

发布时间：2019-01-12 08:51

【摘要】：目的分析SPAN-100评分联合高敏C-反应蛋白(hs-CRP)预测缺血性脑卒中(AIS)静脉溶栓(IVT)后症状性颅内出血(sICH)风险的价值。方法连续纳入2012年5月1日—2016年3月1日在湖北省中西医结合医院神经内科住院进行IVT治疗、并有完整临床资料的AIS患者93例,AIS发病4.5 h内应用rt-PA进行IVT治疗,按溶栓后复查头颅CT或MR和NIHSS评分变化分为sICH组(8例)和非non-sICH组(85例)。分析2组SPAN-100评分、hs-CRP及其相关脑血管病危险因素的差异,并进一步分析影响sICH发生的独立预测因素。采用受试者工作特征(ROC)曲线分析计算曲线下面积(AUC)及95%CI评价SPAN-100评分、hs-CRP和两者联合预测sICH发生的价值。结果 2组基线资料分析表明,sICH组年龄、溶栓前NIHSS评分、溶栓前收缩压、hs-CRP水平和SPAN-100评分阳性明显高于non-sICH组(t=2.766、3.679、3.613、2.305,χ~2=19.079,P均0.05)。单因素分析表明,年龄、溶栓前NIHSS评分、溶栓前收缩压、hs-CRP水平和SPAN-100评分与sICH均呈正相关关系(r=0.278、0.360、0.248、0.235、0.453,P均0.05)。多因素Logistic回归分析表明,年龄大(OR=1.171,95%CI 1.018~1.346)、hs-CRP水平升高(OR=1.258,95%CI 1.032~1.533)、SPAN-100评分阳性(OR=9.729,95%CI 1.386~68.277)是发生sICH的独立预测因素。ROC曲线分析表明,SPAN-100评分AUC=0.726(95%CI 0.503~0.950)、hs-CRP水平AUC=0.711(95%CI0.501~0.921)和两者联合AUC=0.768(95%CI 0.548~0.989),差异均有统计学意义(P0.05)。结论 SPAN-100评分是一种简单、易计算、有效的预测sICH的工具,与hs-CRP联合检测可明显提高预测IVT后sICH的价值。
[Abstract]:Objective to analyze the value of SPAN-100 score combined with Gao Min C-reactive protein (hs-CRP) in predicting (sICH) risk of symptomatic intracranial hemorrhage after (AIS) intravenous thrombolytic (IVT) in ischemic stroke. Methods from May 1, 2012 to March 1, 2016, 93 patients with IVT were admitted to the Department of Neurology, Integrated traditional Chinese and Western Medicine Hospital of Hubei Province, and had complete clinical data. Rt-PA was used for IVT treatment within 4.5 hours after the onset of AIS. According to the changes of CT or MR and NIHSS scores after thrombolysis, the patients were divided into sICH group (8 cases) and non non-sICH group (85 cases). To analyze the difference of SPAN-100 score, hs-CRP and related cerebrovascular risk factors between the two groups, and to further analyze the independent predictive factors that affect the occurrence of sICH. The area under the curve (AUC) and 95%CI were calculated by using the (ROC) curve of the subjects' operating characteristics to evaluate the SPAN-100 score. The value of hs-CRP and the combination of hs-CRP and both were used to predict the occurrence of sICH. Results the baseline data analysis showed that the age, NIHSS score, systolic blood pressure, hs-CRP level and SPAN-100 score in sICH group were significantly higher than those in non-sICH group (t = 2.766 ~ 3.679 / 3.6132.305, 蠂 ~ 219.079P < 0.05). Univariate analysis showed that age, NIHSS score before thrombolytic therapy, systolic blood pressure before thrombolysis, hs-CRP level and SPAN-100 score were positively correlated with sICH (r = 0.2780.360 / 0.248U 0.2350.453n, all P 0.05). Multivariate Logistic regression analysis showed that age (OR=1.171,95%CI 1.018 卤1.346) and hs-CRP level increased (OR=1.258,95%CI 1.032 卤1.533). The positive SPAN-100 score (OR=9.729,95%CI 1.386 + 68.277) was an independent predictor of sICH. ROC curve analysis showed that SPAN-100 score AUC=0.726 (95%CI 0.503 卤0.950). Hs-CRP level AUC=0.711 (95%CI0.501~0.921) and combined AUC=0.768 (95%CI 0.548 卤0.989) were significantly different (P0.05). Conclusion SPAN-100 score is a simple, easy to calculate and effective tool for predicting sICH. Combined detection with hs-CRP can significantly improve the value of predicting sICH after IVT.
【作者单位】： 湖北省中西医结合医院神经内科;
【分类号】：R743.3

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