中国卒中杂志
中國卒中雜誌
중국졸중잡지
CHINESE JOURNAL OF STROKE
2014年
6期
486-492
,共7页
孟霞%王伊龙%赵性泉%王春雪%刘丽萍%潘岳松%荆京%李超%陈宇%王拥军
孟霞%王伊龍%趙性泉%王春雪%劉麗萍%潘嶽鬆%荊京%李超%陳宇%王擁軍
맹하%왕이룡%조성천%왕춘설%류려평%반악송%형경%리초%진우%왕옹군
缺血性卒中%短暂性脑缺血发作%小卒中%风险预测
缺血性卒中%短暫性腦缺血髮作%小卒中%風險預測
결혈성졸중%단잠성뇌결혈발작%소졸중%풍험예측
Ischemic stroke%Transient ischemic attack%Minor stroke%Risk prediction
目的：比较Essen卒中风险分层量表（Essen Stroke Risk Score，ESRS）预测短暂性脑缺血发作（transient ischemic attack，TIA）、缺血性小卒中和缺血性大卒中患者的卒中复发和联合血管事件发生的效度。方法以前瞻性、多中心中国国家卒中登记研究（China National Stroke Registry，CNSR）中连续录入的11384例完成1年随访的TIA、非心房颤动性缺血性卒中的住院患者为研究人群，小卒中定义为入院时缺血性卒中患者的美国国立卫生研究院卒中量表（National Institutes of Health Stroke Scale，NIHSS）评分≤3分，大卒中定义为NIHSS评分＞3分。采用曲线下面积（area under the curve，AUC）评价ESRS对TIA、缺血性小卒中和大卒中患者进行卒中复发和联合血管事件复发风险的分层能力，预测卒中复发和联合血管事件发生的效度。结果本研究有1061例TIA，3254例小卒中，7069例大卒中患者。在TIA患者中，ESRS预测卒中复发AUC=0.57，预测联合血管事件AUC=0.56；小卒中患者中，ESRS预测卒中复发的AUC=0.58，预测联合血管事件AUC=0.59；大卒中患者中，ESRS预测卒中复发的AUC=0.60，预测联合血管事件AUC=0.60。结论 ESRS评分对大卒中的卒中复发/联合血管事件发生的预测效度最高，其次是对小卒中，在TIA中预测效度最低，但是三组人群中差异无显著性。
目的：比較Essen卒中風險分層量錶（Essen Stroke Risk Score，ESRS）預測短暫性腦缺血髮作（transient ischemic attack，TIA）、缺血性小卒中和缺血性大卒中患者的卒中複髮和聯閤血管事件髮生的效度。方法以前瞻性、多中心中國國傢卒中登記研究（China National Stroke Registry，CNSR）中連續錄入的11384例完成1年隨訪的TIA、非心房顫動性缺血性卒中的住院患者為研究人群，小卒中定義為入院時缺血性卒中患者的美國國立衛生研究院卒中量錶（National Institutes of Health Stroke Scale，NIHSS）評分≤3分，大卒中定義為NIHSS評分＞3分。採用麯線下麵積（area under the curve，AUC）評價ESRS對TIA、缺血性小卒中和大卒中患者進行卒中複髮和聯閤血管事件複髮風險的分層能力，預測卒中複髮和聯閤血管事件髮生的效度。結果本研究有1061例TIA，3254例小卒中，7069例大卒中患者。在TIA患者中，ESRS預測卒中複髮AUC=0.57，預測聯閤血管事件AUC=0.56；小卒中患者中，ESRS預測卒中複髮的AUC=0.58，預測聯閤血管事件AUC=0.59；大卒中患者中，ESRS預測卒中複髮的AUC=0.60，預測聯閤血管事件AUC=0.60。結論 ESRS評分對大卒中的卒中複髮/聯閤血管事件髮生的預測效度最高，其次是對小卒中，在TIA中預測效度最低，但是三組人群中差異無顯著性。
목적：비교Essen졸중풍험분층량표（Essen Stroke Risk Score，ESRS）예측단잠성뇌결혈발작（transient ischemic attack，TIA）、결혈성소졸중화결혈성대졸중환자적졸중복발화연합혈관사건발생적효도。방법이전첨성、다중심중국국가졸중등기연구（China National Stroke Registry，CNSR）중련속록입적11384례완성1년수방적TIA、비심방전동성결혈성졸중적주원환자위연구인군，소졸중정의위입원시결혈성졸중환자적미국국립위생연구원졸중량표（National Institutes of Health Stroke Scale，NIHSS）평분≤3분，대졸중정의위NIHSS평분＞3분。채용곡선하면적（area under the curve，AUC）평개ESRS대TIA、결혈성소졸중화대졸중환자진행졸중복발화연합혈관사건복발풍험적분층능력，예측졸중복발화연합혈관사건발생적효도。결과본연구유1061례TIA，3254례소졸중，7069례대졸중환자。재TIA환자중，ESRS예측졸중복발AUC=0.57，예측연합혈관사건AUC=0.56；소졸중환자중，ESRS예측졸중복발적AUC=0.58，예측연합혈관사건AUC=0.59；대졸중환자중，ESRS예측졸중복발적AUC=0.60，예측연합혈관사건AUC=0.60。결론 ESRS평분대대졸중적졸중복발/연합혈관사건발생적예측효도최고，기차시대소졸중，재TIA중예측효도최저，단시삼조인군중차이무현저성。
Objective To prospectively compare the predictive accuracy of the Essen Stroke Risk Score (ESSR) in a large multicenter cohort of Chinese patients with TIA, ischemic minor stroke and major stroke. Methods The data of 11 384 admitted patients with acute ischemic stroke and transient ischemic attack (TIA) who were followed up 1 year was from a multicenter prospective cohort study covering 132 urban hospitals throughout China. Minor stroke was deifned as an National Institutes of Health Stroke Scale (NIHSS) score 3 at the time of ifrst assessment, major stroke was deifned as NIHSS score>3. We evaluated the predictive accuracy of ESRS of both recurrent stroke and combined vascular events in TIA, minor stroke and major stroke with area under the curve (AUC). Results In our study, 1061 cases were TIA patients, 3254 ones were minor stroke patients and 7069 ones were major stroke patients. The ESRS was modestly predictive with AUC=0.57 for recurrent stroke and AUC=0.56 for combined vascular events in TIA patients at 1 year; with AUC=0.58 for recurrent stroke and AUC=0.59 for combined vascular events in minor stroke patients; with AUC=0.60 for recurrent stroke and AUC=0.60 for combined vascular events in major stroke patients. Conclusion ESRS is equally able to predict the risk of recurrent stroke and combined vascular events in TIA, minor stroke and major stroke, although the predictive accuracy of the ESRS is highest in major stroke, second in minor stroke and lowest in TIA.
