中华神经医学杂志
中華神經醫學雜誌
중화신경의학잡지
Chinese Journal of Neuromedicine
2015年
8期
775-779
,共5页
卢万俊%仇圣刚%刘静%彭剑
盧萬俊%仇聖剛%劉靜%彭劍
로만준%구골강%류정%팽검
缺血性脑卒中%动脉粥样硬化%前循环%Essen卒中风险评估量表%脑血管狭窄%危险性评估%预测
缺血性腦卒中%動脈粥樣硬化%前循環%Essen卒中風險評估量錶%腦血管狹窄%危險性評估%預測
결혈성뇌졸중%동맥죽양경화%전순배%Essen졸중풍험평고량표%뇌혈관협착%위험성평고%예측
Cerebral ischemia stroke%Atherosclerosis%Anterior circulation%Essen stroke risk scale%Cerebrovascular stenosis%Risk assessment%Prediction
目的 探讨Essen卒中风险评估量表(ESRS)评分对动脉粥样硬化性前循环急性缺血性脑卒中患者脑血管狭窄的预测价值. 方法 选择扬州大学附属扬州市江都人民医院神经内科自2011年6月至2013年6月收治的接受头颅+颈部CT血管造影检查的动脉粥样硬化性前循环急性缺血性脑卒中患者98例进行ESRS评分,根据ESRS评分分为低危组35例、高危组44例、极高危组19例,分析ESRS评分与患者脑血管形态学特点的关系及其对脑血管狭窄的预测价值.结果 (1)3组患者间脑血管狭窄病变部位(单纯颅内段、单纯颅外段、颅内颅外段同时)分布差异无统计学意义(P＞0.05).(2)在症状侧和非症状侧大血管中,ESRS评分与脑血管狭窄程度之间均不仅存在相关关系且均为线性关系(x2=9.784,P=0.002x2=9.215,p=0.002).(3)当ESRS评分≥3分时,预测脑血管轻度狭窄的敏感性为63.6％,特异性为53.4％,受试者工作特征曲线(ROC)曲线下面积为0.595 (P=0.182,95％CI:0.445～0.764);预测脑血管中度、重度狭窄及闭塞的敏感性为60.3％,特异性为66.7％,ROC曲线下面积为0.679(P=0.005,95％CI:0.553～0.805). 结论 对动脉粥样硬化性前循环急性缺血性脑卒中患者应用ESRS评分能够在一定程度上反映患者脑血管的狭窄程度.ESRS评分≥3分的高危人群应重视脑血管检查,以为及早、有效的分层十预提供一定参考依据.
目的 探討Essen卒中風險評估量錶(ESRS)評分對動脈粥樣硬化性前循環急性缺血性腦卒中患者腦血管狹窄的預測價值. 方法 選擇颺州大學附屬颺州市江都人民醫院神經內科自2011年6月至2013年6月收治的接受頭顱+頸部CT血管造影檢查的動脈粥樣硬化性前循環急性缺血性腦卒中患者98例進行ESRS評分,根據ESRS評分分為低危組35例、高危組44例、極高危組19例,分析ESRS評分與患者腦血管形態學特點的關繫及其對腦血管狹窄的預測價值.結果 (1)3組患者間腦血管狹窄病變部位(單純顱內段、單純顱外段、顱內顱外段同時)分佈差異無統計學意義(P＞0.05).(2)在癥狀側和非癥狀側大血管中,ESRS評分與腦血管狹窄程度之間均不僅存在相關關繫且均為線性關繫(x2=9.784,P=0.002x2=9.215,p=0.002).(3)噹ESRS評分≥3分時,預測腦血管輕度狹窄的敏感性為63.6％,特異性為53.4％,受試者工作特徵麯線(ROC)麯線下麵積為0.595 (P=0.182,95％CI:0.445～0.764);預測腦血管中度、重度狹窄及閉塞的敏感性為60.3％,特異性為66.7％,ROC麯線下麵積為0.679(P=0.005,95％CI:0.553～0.805). 結論 對動脈粥樣硬化性前循環急性缺血性腦卒中患者應用ESRS評分能夠在一定程度上反映患者腦血管的狹窄程度.ESRS評分≥3分的高危人群應重視腦血管檢查,以為及早、有效的分層十預提供一定參攷依據.
목적 탐토Essen졸중풍험평고량표(ESRS)평분대동맥죽양경화성전순배급성결혈성뇌졸중환자뇌혈관협착적예측개치. 방법 선택양주대학부속양주시강도인민의원신경내과자2011년6월지2013년6월수치적접수두로+경부CT혈관조영검사적동맥죽양경화성전순배급성결혈성뇌졸중환자98례진행ESRS평분,근거ESRS평분분위저위조35례、고위조44례、겁고위조19례,분석ESRS평분여환자뇌혈관형태학특점적관계급기대뇌혈관협착적예측개치.결과 (1)3조환자간뇌혈관협착병변부위(단순로내단、단순로외단、로내로외단동시)분포차이무통계학의의(P＞0.05).(2)재증상측화비증상측대혈관중,ESRS평분여뇌혈관협착정도지간균불부존재상관관계차균위선성관계(x2=9.784,P=0.002x2=9.215,p=0.002).(3)당ESRS평분≥3분시,예측뇌혈관경도협착적민감성위63.6％,특이성위53.4％,수시자공작특정곡선(ROC)곡선하면적위0.595 (P=0.182,95％CI:0.445～0.764);예측뇌혈관중도、중도협착급폐새적민감성위60.3％,특이성위66.7％,ROC곡선하면적위0.679(P=0.005,95％CI:0.553～0.805). 결론 대동맥죽양경화성전순배급성결혈성뇌졸중환자응용ESRS평분능구재일정정도상반영환자뇌혈관적협착정도.ESRS평분≥3분적고위인군응중시뇌혈관검사,이위급조、유효적분층십예제공일정삼고의거.
Objective To investigate the predictive value of Essen stroke risk scale (ESRS) scores in stenosis of patients with anterior circulation acute ischemic stroke.Methods A total of 98 patients with atherosclerotic stroke in anterior circulation,admitted to our hospital from June 2011 to June 2013,were selected and performed head+neck CTA inspection cycle and ESRS.According to the ESRS scores,the patients were divided into low risk group (n=35),high risk group (n=44) and extremely high risk group (n=19).The relationship between the cerebrovascular morphology characteristics and ESRS scores were analyzed,and the predictive value of ESRS scores in stenosis was analyzed.Results (1) The distributions of these stenosis (the intracranial segment,the extracranial segment and combined intracranial and extracranial segments) were not significantly different among the three groups (P＞0.05).(2) Following the increase of ESRS scores,the degrees of luminal stenosis showed an increased trend in both circulation symptom side and non-symptom side (x2=9.784,P=0.002;xx2=9.215,P=0.002).(3) When the ESRS scores were higher than or equal to 3 points,the sensitivity of predicting mild stenosis was 63.6％,specificity 53.4％,with area under receiver operating characteristic curve (AUC) of 0.595 (P=0.182,95％CI:0.445-0.764);the sensitivity of predicting moderate stenosis,severe stenosis and occlusion was 60.3％,specificity 66.7％,with AUC of 0.679 (P=0.005,95％CI:0.553-0.805).Conclusions ESRS scores can predict the severity of the stenosis in patients with atherosclerotic cerebral stroke of anterior circulation.The patients having ESRS ≥ 3 scores should accept cerebrovascular examination to provide a certain basis for early and effective stratified intervention.
