缺血性卒中病因分型：CISS、SPARKLE、TOAST一致性分析
發(fā)布時間：2018-10-05 15:50
【摘要】：背景及目的:目前存在數(shù)種缺血性卒中病因分型系統(tǒng),合適的分型系統(tǒng)應當具備高的信度及效度特點,以便于在不同研究中心應用。急性卒中抗凝治療試驗(Trial of Org 10172 in Acute Stroke Treatment,TOAST)分型是經(jīng)典的病因分型系統(tǒng)。中國缺血性卒中亞型分型(Chinese Ischemic Stroke Subclassification,CISS)、缺血性卒中分型系統(tǒng)亞型(Subtypes of Ischemic Stroke Classification System,SPARKLE)是較新出現(xiàn)的病因分型系統(tǒng),三者之間還沒有進行過一致性分析。本文目的旨在探討CISS、SPARKLE、TOAST三者之間一致性情況及CISS病因分型系統(tǒng)的內(nèi)在一致性分析。方法:數(shù)據(jù)來自2015.10.01至2016.4.19首都醫(yī)科大學附屬北京天壇醫(yī)院神經(jīng)病學中心血管神經(jīng)病學科收住院623例急性缺血性腦卒中患者;根據(jù)本研究的入組標準及排除標準,407例為符合要求的首次腦梗死發(fā)病患者,然后結合相關研究樣本量情況,連續(xù)抽取299例患者作為本研究的入組樣本量,并進行病因分型及一致性分析。結果:CISS、SPARKLE、TOAST三者之間具有肯定一致性:CISS與SPARKLE(kappa值=0.684,P㩳0.001)、CISS與TOAST(kappa值=0.615,P㩳0.001)、SPARKLE與TOAST(kappa值=0.675,P㩳0.001)。CISS病因分型內(nèi)在一致性較好(kappa值=0.857,P㩳0.001)。另外各病因亞型之間差異性分析結果為:對于大動脈粥樣硬化(Large-artery Atherosclerosis)、不明原因(Undetermined Etiology)病因亞型,三者之間均有顯著差異性,P㩳0.05;對于心源性栓塞(Cardioembolism)、其它病因(Other Etiology)中,三者之間均無顯著性差異,P㧐0.05;在小血管病病因(Small Vessel Disease)中,CISS與SPARKLE、CISS與TOAST之間存在顯著性差異,P㩳0.05,但SPARKLE與TOAST之間無顯著性差異,P=0.824。結論:CISS、SPARKLE、TOAST三者病因分型系統(tǒng)之間具有肯定一致性;CISS病因分型內(nèi)在一致性較好,適合不同研究中心之間應用及進行數(shù)據(jù)對比研究。
[Abstract]:Background and objective: there are several etiological classification systems for ischemic stroke. The suitable classification system should have the characteristics of high reliability and validity in order to be used in different research centers. Acute stroke anticoagulant therapy trial (Trial of Org 10172 in Acute Stroke Treatment,TOAST) is a classic etiological classification system. Chinese ischemic stroke subtype (Chinese Ischemic Stroke Subclassification,CISS) and ischemic stroke subtype (Subtypes of Ischemic Stroke Classification System,SPARKLE) are relatively new etiological classification systems. There has not been a consistent analysis among them. The purpose of this study was to explore the consistency among the three CISS,SPARKLE,TOAST and the analysis of the internal consistency of the etiological classification system of CISS. Methods: the data were collected from 623 patients with acute ischemic stroke in neurology department of Temple of Heaven Hospital affiliated to Beijing Capital Medical University from January 1 to April 19, 2015.The data were collected from 623 patients with acute ischemic stroke. According to the criteria of admission and exclusion, 407 patients with first cerebral infarction were selected as the sample size of this study, and 299 consecutive patients were selected as the sample size of this study. The etiological classification and consistency were analyzed. The results showed that there was a definite consistency between the two parts: the SPARKLE (kappa value was 0.684? 0.001) CISS and TOAST (kappa value 0. 615? 0.001) SPARKLE and TOAST (kappa value 0. 675? The internal consistency of the etiological classification of CISS was good (kappa value: 0.857P? 0.001) The results showed that there were significant differences in the etiological subtypes of Large-artery Atherosclerosis), (Undetermined Etiology) with unknown cause). There was no significant difference among the three groups in other etiological (Other Etiology) of cardiac embolism (Cardioembolism),). In the etiology of small vascular disease (Small Vessel Disease), there was significant difference between CISS and SPARKLE,CISS and TOAST. But there was no significant difference between SPARKLE and TOAST. Conclusion there is a definite consistency among the etiological classification system of SPARKLETOAST, which is suitable for the application of different research centers and the comparative study of data.
【學位授予單位】：首都醫(yī)科大學
【學位級別】：碩士
【學位授予年份】：2017
【分類號】：R743.3
本文編號：2253969
[Abstract]:Background and objective: there are several etiological classification systems for ischemic stroke. The suitable classification system should have the characteristics of high reliability and validity in order to be used in different research centers. Acute stroke anticoagulant therapy trial (Trial of Org 10172 in Acute Stroke Treatment,TOAST) is a classic etiological classification system. Chinese ischemic stroke subtype (Chinese Ischemic Stroke Subclassification,CISS) and ischemic stroke subtype (Subtypes of Ischemic Stroke Classification System,SPARKLE) are relatively new etiological classification systems. There has not been a consistent analysis among them. The purpose of this study was to explore the consistency among the three CISS,SPARKLE,TOAST and the analysis of the internal consistency of the etiological classification system of CISS. Methods: the data were collected from 623 patients with acute ischemic stroke in neurology department of Temple of Heaven Hospital affiliated to Beijing Capital Medical University from January 1 to April 19, 2015.The data were collected from 623 patients with acute ischemic stroke. According to the criteria of admission and exclusion, 407 patients with first cerebral infarction were selected as the sample size of this study, and 299 consecutive patients were selected as the sample size of this study. The etiological classification and consistency were analyzed. The results showed that there was a definite consistency between the two parts: the SPARKLE (kappa value was 0.684? 0.001) CISS and TOAST (kappa value 0. 615? 0.001) SPARKLE and TOAST (kappa value 0. 675? The internal consistency of the etiological classification of CISS was good (kappa value: 0.857P? 0.001) The results showed that there were significant differences in the etiological subtypes of Large-artery Atherosclerosis), (Undetermined Etiology) with unknown cause). There was no significant difference among the three groups in other etiological (Other Etiology) of cardiac embolism (Cardioembolism),). In the etiology of small vascular disease (Small Vessel Disease), there was significant difference between CISS and SPARKLE,CISS and TOAST. But there was no significant difference between SPARKLE and TOAST. Conclusion there is a definite consistency among the etiological classification system of SPARKLETOAST, which is suitable for the application of different research centers and the comparative study of data.
【學位授予單位】：首都醫(yī)科大學
【學位級別】：碩士
【學位授予年份】：2017
【分類號】：R743.3
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