中华神经科杂志
中華神經科雜誌
중화신경과잡지
Chinese Journal of Neurology
2012年
1期
32-35
,共4页
脑缺血%卒中%动脉粥样硬化%血栓形成
腦缺血%卒中%動脈粥樣硬化%血栓形成
뇌결혈%졸중%동맥죽양경화%혈전형성
Brain ischemia%Stroke%Atherosclerosis%Thrombosis
目的 评价ASCO与改良TOAST分型方法对卒中亚型分型的准确性.方法 425例首发急性脑梗死患者分别经ASCO与改良TOAST病因分型方法进行卒中病因诊断,比较两种分型方法对卒中病因诊断的准确性.结果 与改良TOAST分型相比,ASCO 1级证据未明显降低不明病因卒中的诊断比例(15.5％比16.2％,x2=0.09,P=0.795),动脉粥样硬化性卒中的发病率60.2％,与改良TOAST分型相近(57.9％,x2=2.68,P=0.132),小动脉病变、心源性卒中的诊断比例略低于改良TOAST分型(13.4％比14.8％,x2=1.30,P=0.238；8.5％比8.7％,X2=0.00,P=1.000).2种分型方法对动脉粥样硬化性卒中和小动脉病变的诊断均具有很好的一致性(κ值均大于0.81),对心源性卒中的诊断具有较好的一致性(κ值0.61～0.80).结论 ASCO分型、改良TOAST分型方法对各卒中亚型的诊断均存在一致性,ASCO分型的设计特点能更充分地利用临床信息,弥补改良TOAST分型对多病因卒中患者病因诊断的不足.
目的 評價ASCO與改良TOAST分型方法對卒中亞型分型的準確性.方法 425例首髮急性腦梗死患者分彆經ASCO與改良TOAST病因分型方法進行卒中病因診斷,比較兩種分型方法對卒中病因診斷的準確性.結果 與改良TOAST分型相比,ASCO 1級證據未明顯降低不明病因卒中的診斷比例(15.5％比16.2％,x2=0.09,P=0.795),動脈粥樣硬化性卒中的髮病率60.2％,與改良TOAST分型相近(57.9％,x2=2.68,P=0.132),小動脈病變、心源性卒中的診斷比例略低于改良TOAST分型(13.4％比14.8％,x2=1.30,P=0.238；8.5％比8.7％,X2=0.00,P=1.000).2種分型方法對動脈粥樣硬化性卒中和小動脈病變的診斷均具有很好的一緻性(κ值均大于0.81),對心源性卒中的診斷具有較好的一緻性(κ值0.61～0.80).結論 ASCO分型、改良TOAST分型方法對各卒中亞型的診斷均存在一緻性,ASCO分型的設計特點能更充分地利用臨床信息,瀰補改良TOAST分型對多病因卒中患者病因診斷的不足.
목적 평개ASCO여개량TOAST분형방법대졸중아형분형적준학성.방법 425례수발급성뇌경사환자분별경ASCO여개량TOAST병인분형방법진행졸중병인진단,비교량충분형방법대졸중병인진단적준학성.결과 여개량TOAST분형상비,ASCO 1급증거미명현강저불명병인졸중적진단비례(15.5％비16.2％,x2=0.09,P=0.795),동맥죽양경화성졸중적발병솔60.2％,여개량TOAST분형상근(57.9％,x2=2.68,P=0.132),소동맥병변、심원성졸중적진단비례략저우개량TOAST분형(13.4％비14.8％,x2=1.30,P=0.238；8.5％비8.7％,X2=0.00,P=1.000).2충분형방법대동맥죽양경화성졸중화소동맥병변적진단균구유흔호적일치성(κ치균대우0.81),대심원성졸중적진단구유교호적일치성(κ치0.61～0.80).결론 ASCO분형、개량TOAST분형방법대각졸중아형적진단균존재일치성,ASCO분형적설계특점능경충분지이용림상신식,미보개량TOAST분형대다병인졸중환자병인진단적불족.
Objective To compare the differences in stroke subtype classification between ASCO and modified TOAST.Methods All 425 first-ever ischemic stroke patients were recruited and classified into different stroke subtypes according to the ASCO and modified TOAST criteria.Results Comparing ASCO grade 1 with modified TOAST,more patients were classified as atherosclerosis (60.2％ vs 57.9％ ; x2 =2.68,P=0.132) and fewer as small artery disease and cardiac disease subtype (13.4％ vs 14.8％ and 8.5％ vs 8.7％ ; x2 =1.30 and 0.00,P =0.238 and 1.000,respectively).ASCO grade 1 did not reduce the proportion of cause undetermined patients compared with modified TOAST ( 15.5％ vs 16.2％ ; x2 =0.09,P =0.795 ). Agreement was showed in every subtype categories between the two approaches.Agreement for atherosclerotic cause and small artery disease was very good ( all κ over 0.81 ),and for the cardiac disease subtype was good (κ: 0.61-0.80). Conclusion Agreement can be found in every subtype categories between ASCO and modified TOAST classification.ASCO grade 1 does not reduce the proportion of cause undetermined cases compared with modified TOAST,but the subtype categories characteristics of the two approaches should be considered in practice.
