[1]林志超,潘思金,谢玉龙,等.急性缺血性脑卒中静脉溶栓预后不良预警模型构建[J].中国医学物理学杂志,2024,41(4):421-425.[doi:DOI:10.3969/j.issn.1005-202X.2024.04.004]
　LIN Zhichao,PAN Sijin,XIE Yulong,et al.Construction of warning model for bleak prognosis of acute ischemic stroke treated with intravenous thrombolysis[J].Chinese Journal of Medical Physics,2024,41(4):421-425.[doi:DOI:10.3969/j.issn.1005-202X.2024.04.004]
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急性缺血性脑卒中静脉溶栓预后不良预警模型构建()
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《中国医学物理学杂志》[ISSN:1005-202X/CN:44-1351/R]

卷:
41卷
期数:
2024年第4期
页码:
421-425
栏目:
医学影像物理
出版日期:
2024-04-25

文章信息/Info

Title:
Construction of warning model for bleak prognosis of acute ischemic stroke treated with intravenous thrombolysis
文章编号:
1005-202X（2024）04-0421-05
作者:
林志超1; 潘思金1; 谢玉龙1; 黄立安2
1.暨南大学附属第一医院影像中心， 广东 广州 510630； 2.暨南大学附属第一医院神经内科， 广东 广州 510630
Author(s):
LIN Zhichao1;  PAN Sijin1;  XIE Yulong1;  HUANG Lian2
1. Imaging Center, the First Affiliated Hospital of Jinan University, Guangzhou 510630, China 2. Department of Neurology, the First Affiliated Hospital of Jinan University, Guangzhou 510630, China
关键词:
急性缺血性脑卒中; 静脉溶栓; NIHSS; DWI-ASPECTS; 预警模型
Keywords:
Keywords: acute ischemic stroke intravenous thrombolysis NIHSS DWI-ASPECTS warning model
分类号:
R743.3；R816.1
DOI:
DOI:10.3969/j.issn.1005-202X.2024.04.004
文献标志码:
A
摘要:
目的：对急性缺血性脑卒中（AIS）静脉溶栓的预后不良影响因素进行分析，构建其不良预警模型为其并发症防治提供依据。方法：收集256例AIS患者，4.5 h内均行静脉溶栓及用药后1 h内进行DWI检查，治疗3个月后按MRS评分结果分为82例预后不良组（>2分）和174例预后良好组（≤2分，采用Logistic回归分析预后不良影响因素，构建其预警模型及使用ROC曲线分析模型预测效能。结果：低DWI-ASPECTS和高NIHSS评分均是预后不良的危险因素（P=0.01）。ROC曲线显示，当NIHSS≥5分、DWI-ASPECTS<8分、NIHSS≥5分且DWI-ASPECTS<8分时，对静脉溶栓预后不良预测灵敏度、特异度、阳性率及阴性率分别为92%、47%、45%、92%，79%、80%、65%、89%，93%、73%、69%、94%，差别有统计学意义（P<0.01）。结论：AIS静脉溶栓预后不良危险因素是高基线NIHSS评分和低基线DWI-ASPECTS评分，联合构建其预后不良预警模型有助于防治静脉溶栓后并发症。
Abstract:
Abstract: Objective To analyze the adverse prognostic factors for acute ischemic stroke (AIS) treated with intravenous thrombolysis, and construct a warning model to provide a basis for the prevention and treatment of complications. Methods A total of 256 AIS patients were collected and treated with intravenous thrombolysis within 4.5 h after cerebral hemorrhage and underwent DWI examination within 1 h after medication. Three months after treatment, they were divided into poor prognosis group (n=82, MRS score > 2) and good prognosis group (n=174, MRS score ≤ 2). Logistic regression analysis was used to analyze the adverse prognostic factors for constructing the warning model whose predictive efficacy was evaluated with ROC curve. Results Low DWI-ASPECTS and high NIHSS score were both risk factors for poor prognosis (P=0.01). The ROC curve analysis showed that for predicting poor prognosis, the model had sensitivity, specificity, positive and negative rates of 92%, 47%, 45%, 92% in NIHSS score ≥ 5, 79%, 80%, 65%, 89% in DWI-ASPECTS score < 8, and 93%, 73%, 69%, 94% in NIHSS score ≥ 5 and DWI-ASPECTS score < 8, with significant differences (P<0.01). Conclusion High baseline NIHSS score and low baseline DWI-ASPECTS score are the risk factors for poor prognosis in AIS, and the combined construction of a warning model is helpful to prevent and treat complications after intravenous thrombolysis.

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备注/Memo

备注/Memo:
【收稿日期】2023-10-13 【基金项目】国家自然科学基金（81971120）；高校人文社会科学重点研究基地重大项目（16JJD190003）；广州市天河区科技计划项目卫生重点项目（2018YZ003）；暨南大学附属第一医院教改项目（SPJG202301） 【作者简介】林志超，副主任技师，研究方向：卒中影像及影像技师人力资源管理，E-mail: lzcjn@126.com
更新日期/Last Update: 2024-04-25