前后循环梗死评分系统:1种评估急性缺血性卒中患者预后的新方法

彭世鑫, 仇玉龙, 朱继, 张晓冬, 蒋理, 徐睿

PDF(1357 KB)
PDF(1357 KB)
重庆医科大学学报 ›› 2024, Vol. 49 ›› Issue (02) : 217-221. DOI: 10.13406/j.cnki.cyxb.003427
临床研究 DOI:10.13406/j.cnki.cyxb.003427

前后循环梗死评分系统:1种评估急性缺血性卒中患者预后的新方法

作者信息 +

Anterior and posterior circulation infarction image score(APCIIS),a novel approach to evaluate the prognosis of patients with acute ischemic stroke

Author information +
History +

摘要

目的 开发并验证一种新型急性缺血性脑卒中(acute ischemic stroke,AIS)评分系统-前后循环梗死评分系统(anterior and posterior circulation infarction image score,APCIIS)。 方法 回顾性分析2020年6月至2021年6月在重庆医科大学附属第一医院收治的163例急性缺血性卒中患者的临床资料。将患者分为前循环AIS组(n=109)及后循环AIS组(n=54)。利用单因素和多因素分析影响前循环AIS及后循环AIS患者预后情况的危险因素。以血栓负荷评分(the clot burden score,CBS)及基底动脉闭塞评分(the basilar artery on computed tomography angiography score,BATMAN)为参考,绘制受试者工作特征曲线,分析该新型评分(APCIIS)预后评估的价值。 结果 在前循环AIS组,APCIIS的预后评估价值虽然未能优于CBS,但显示出相对更高的敏感度86.8%、特异度90.1%及曲线下面积0.939。在后循环AIS组,APCIIS的预后价值优于BATMAN评分。 结论 APCIIS是预测急性缺血性脑卒中患者预后的1种方便可靠的办法。

Abstract

Objective Development and validation of a novel acute ischemic stroke(AIS) scoring system: Anterior and posterior circulation infarction image score(APCIIS). Methods Retrospective analysis of clinical data from 163 patients with acute ischemic stroke admitted to the First Affiliated Hospital of Chongqing Medical University from 2020/6 to 2021/6. The patients were divided into anterior circulation AIS group(n=109) and posterior circulation AIS group(n=54). Univariate and multivariate analyses were performed to identify risk factors affecting the prognosis of patients with AIS. Using the Clot Burden Score(CBS) and the Basilar Artery on Computed Tomography Angiography score(BATMAN) as references,receiver operating characteristic(ROC) curves were plotted to analyze the predictive value of the novel scoring system(APCIIS) for prognosis assessment. Results In the anterior circulation AIS group,although the prognostic value of APCIIS was not superior to CBS,it demonstrated relatively higher sensitivity of 86.8%,specificity of 90.1%,and an area under the curve of 0.939. In the posterior circulation AIS group,APCIIS showed better prognostic value than the BATMAN score. Conclusion APCIIS is a convenient and reliable method for predicting the prognosis of patients with AIS.

关键词

急性前循环缺血性卒中 / 急性后循环缺血性卒中 / 预后

Key words

anterior circulation acute ischemic stroke / posterior circulation acute ischemic stroke / prognosis

中图分类号

R743.33

引用本文

导出引用
彭世鑫 , 仇玉龙 , 朱继 , . 前后循环梗死评分系统:1种评估急性缺血性卒中患者预后的新方法. 重庆医科大学学报. 2024, 49(02): 217-221 https://doi.org/10.13406/j.cnki.cyxb.003427
Peng Shixin, Qiu Yulong, Zhu Ji, et al. Anterior and posterior circulation infarction image score(APCIIS),a novel approach to evaluate the prognosis of patients with acute ischemic stroke[J]. Journal of Chongqing Medical University. 2024, 49(02): 217-221 https://doi.org/10.13406/j.cnki.cyxb.003427

参考文献

1
Donnan GA Fisher M MacLeod M,et al. Stroke[J]. Lancet2008371(9624):1612-1623.
2
Pu LY Wang L Zhang RJ,et al. Projected global trends in ischemic stroke incidence,deaths and disability-adjusted life years from 2020 to 2030[J]. Stroke202354(5):1330-1339.
3
GBD Stroke Collaborators. Global,regional,and national burden of stroke and its risk factors,1990-2019:a systematic analysis for the Global Burden of Disease Study 2019[J]. Lancet Neurol202120(10):795-820.
4
Kloska SP. Automated detection of large vessel occlusion in acute stroke:faster imaging assessment for faster treatment[J]. Radiology2021298(3):671-672.
5
Albers GW Marks MP Kemp S,et al. Thrombectomy for stroke at 6 to 16 hours with selection by perfusion imaging[J]. N Engl J Med2018378(8):708-718.
6
Campbell BCV Mitchell PJ Kleinig TJ,et al. Endovascular therapy for ischemic stroke with perfusion-imaging selection[J]. N Engl J Med2015372(11):1009-1018.
7
Beauchamp NJ Jr Barker PB Wang PY,et al. Imaging of acute cerebral ischemia[J]. Radiology1999212(2):307-324.
8
Torres-Mozqueda F He J Yeh IB,et al. An acute ischemic stroke classification instrument that includes CT or MR angiography:the Boston Acute Stroke Imaging Scale[J]. AJNR Am J Neuroradiol200829(6):1111-1117.
9
Barber PA Demchuk AM Zhang J,et al. Validity and reliability of a quantitative computed tomography score in predicting outcome of hyperacute stroke before thrombolytic therapy. ASPECTS Study Group. Alberta Stroke Programme Early CT Score[J]. Lancet2000355(9216):1670-1674.
10
Yoo AJ Berkhemer OA Fransen PSS,et al. Effect of baseline Alberta Stroke Program Early CT Score on safety and efficacy of intra-arterial treatment:a subgroup analysis of a randomised phase 3 trial(MR CLEAN)[J]. Lancet Neurol201615(7):685-694.
11
Kwah LK Diong J. National institutes of health stroke scale(NIHSS)[J]. J Physiother201460(1):61.
12
Meyer BC Hemmen TM Jackson CM,et al. Modified National Institutes of Health Stroke Scale for use in stroke clinical trials:prospective reliability and validity[J]. Stroke200233(5):1261-1266.
13
Goyal M Demchuk AM Menon BK,et al. Randomized assessment of rapid endovascular treatment of ischemic stroke[J]. N Engl J Med2015372(11):1019-1030.
14
Puetz V Dzialowski I Hill MD,et al. Intracranial thrombus extent predicts clinical outcome,final infarct size and hemorrhagic transformation in ischemic stroke:the clot burden score[J]. Int J Stroke20083(4):230-236.
15
Alemseged F Shah DG Diomedi M,et al. The basilar artery on computed tomography angiography prognostic score for basilar artery occlusion[J]. Stroke201748(3):631-637.
16
Aerden L Luijckx GJ Ricci S,et al. Validation of the Oxfordshire Community Stroke Project syndrome diagnosis derived from a standard symptom list in acute stroke[J]. J Neurol Sci2004220(1/2):55-58.
17
Mead GE Lewis SC Wardlaw JM,et al. How well does the Oxfordshire community stroke project classification predict the site and size of the infarct on brain imaging?[J]. J Neurol Neurosurg Psychiatry200068(5):558-562.
18
Wardlaw JM Dennis MS Lindley RI,et al. The validity of a simple clinical classification of acute ischaemic stroke[J]. J Neurol1996243(3):274-279.
19
Phipps MS Cronin CA. Management of acute ischemic stroke[J]. BMJ2020368:l6983.
20
Banks JL Marotta CA. Outcomes validity and reliability of the modified Rankin scale:implications for stroke clinical trials:a literature review and synthesis[J]. Stroke200738(3):1091-1096.
21
Lee KY Han SW Kim SH,et al. Early recanalization after intravenous administration of recombinant tissue plasminogen activator as assessed by pre- and post-thrombolytic angiography in acute ischemic stroke patients[J]. Stroke200738(1):192-193.
22
Sims JR Rordorf G Smith EE,et al. Arterial occlusion revealed by CT angiography predicts NIH stroke score and acute outcomes after Ⅳ tPA treatment[J]. AJNR Am J Neuroradiol200526(2):246-251.
23
Schonewille WJ Wijman CA Michel P,et al. Treatment and outcomes of acute basilar artery occlusion in the Basilar Artery International Cooperation Study(BASICS):a prospective registry study[J]. Lancet Neurol20098(8):724-730.
24
Sairanen T Strbian D Soinne L,et al. Intravenous thrombolysis of basilar artery occlusion:predictors of recanalization and outcome[J]. Stroke201142(8):2175-2179.
25
Zeng QT Tao WD Lei CY,et al. Etiology and risk factors of posterior circulation infarction compared with anterior circulation infarction[J]. J Stroke Cerebrovasc Dis201524(7):1614-1620.
26
Lu WT Du WT Lu DS,et al. Predictive value of serum initial brain natriuretic peptide and troponin on functional prognosis in noncardiogenic patients with anterior and posterior circulation cerebral infarction[J]. Arq Neuropsiquiatr202280(10):985-993.
27
Kwak HS Park JS. Mechanical thrombectomy in basilar artery occlusion:clinical outcomes related to posterior circulation collateral score[J]. Stroke202051(7):2045-2050.
28
Da Ros V Meschini A Gandini R,et al. Proposal for a vascular computed tomography-based grading system in posterior circulation stroke:a single-center experience[J]. J Stroke Cerebrovasc Dis201625(2):368-377.
29
van der Hoeven EJ McVerry F Vos JA,et al. Collateral flow predicts outcome after basilar artery occlusion:the posterior circulation collateral score[J]. Int J Stroke201611(7):768-775.

评论

PDF(1357 KB)

Accesses

Citation

Detail

段落导航
相关文章

/