本文關鍵詞： 腦梗死 椎基底動脈供血不足 ASTRAL量表評分 預后 評估　出處：《中國全科醫(yī)學》2016年09期 　論文類型：期刊論文

【摘要】：目的探討ASTRAL量表評分對后循環(huán)急性腦梗死(ACI)患者預后的評估價值。方法選擇2011年6月—2014年6月于華北理工大學附屬醫(yī)院神經內科住院的經顱腦MRI明確診斷的后循環(huán)ACI患者211例為研究對象。患者在入院24 h內采用ASTRAL量表進行評分,發(fā)病30 d時采用改良Rankin量表(mRS)評分進行預后評估。按照mRS評分將患者分為預后良好組和預后不良組。描繪ASTRAL量表評分評估后循環(huán)ACI患者預后的受試者工作特征曲線(ROC曲線),計算ROC曲線下面積(AUC)、最大Youden指數,找出理想界值;以預后為因變量,ASTRAL量表評分為自變量,進行Fisher法線性判別分析。結果預后良好組167例,預后不良組44例。預后良好組患者ASTRAL量表評分低于預后不良組(t=-7.66,P0.05)。預后不良率隨ASTRAL量表評分增加而升高(P0.05)。ASTRAL量表評分評估后循環(huán)ACI患者預后的AUC為0.788,95%CI(0.712,0.864),理想界值為19分,靈敏度為72.7%,特異度為68.9%,正確率為69.7%。按照理想界值將患者分為高分組(≥19分,84例)和低分組(19分,127例)。高分組患者預后不良率高于低分組(χ~2=25.14,P0.01)。Fisher法線性判別分析得到判別方程式:Y_0=-6.807+0.709X,Y_1=-12.191+0.972X,其中Y_0為預后良好,Y_1為預后不良。用該判別方程式對患者預后進行判別,正確率為71.8%,進一步行Bayes交互驗證,計算準確度為71.7%,提示該判別方程式有較好的穩(wěn)定性。結論 ASTRAL量表評分對后循環(huán)ACI患者預后有一定的評估價值。
[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，

本文編號：1537362