Zhongguo cuzhong zazhi (Jun 2019)

探讨ASPECTS、DRAGON和SEDAN评分对我国急性缺血性卒中患者静脉溶栓后急性期内出血转化的预测价值 Predictive Value of ASPECTS, DRAGON and SEDAN Scores for Hemorrhagic Transformation after Intravenous Thrombolysis in Patients with Acute Ischemic Stroke in China

  • 郑国将，毛相濡，丁刚玉，王星，徐建华，靳令经，聂志余

DOI
https://doi.org/10.3969/j.issn.1673-5765.2019.06.004
Journal volume & issue
Vol. 14, no. 6
pp. 533 – 540

Abstract

Read online

【摘要】 目的 探讨Alberta卒中项目早期CT评分（Alberta stroke program early CT score，ASPECTS）、DRAGON评分和SEDAN评分对我国急性缺血性卒中患者静脉溶栓后急性期内出血转化的预测价值。 方法 回顾性连续收集2012年12月-2017年12月在同济大学附属同济医院神经内科急诊收入的接受静脉溶栓治疗的急性缺血性卒中患者的临床资料，记录有关基线资料，并使用ASPECTS、DRAGON和SEDAN 3个量表进行评分。以住院期间出血转化作为观察终点。应用受试者工作特征（receiver operating characteristic，ROC）曲线评估量表对静脉溶栓后出血转化的预测诊断价值，ROC曲线下面积采用C值表示，通过C值比较3个量表的预测价值；使用Hosmer-Lemeshow（H-L）拟合优度[χ2（P）]检验法判断各模型与实际结果的拟合度；进行Logistic回归分析探讨各评分与溶栓后出血转化的关系。 结果 共纳入199例患者，ASPECTS、DRAGON和SEDAN评分在总体患者中C值分别为0.889、0.810和0.793；前循环中C值分别为0.889、0.823和0.788；男性组中C值分别为0.893、0.788和0.818；女性组中C值分别为0.882、0.808和0.720（均P0.05). The OR in logistic regression analysis of the three scales in all patients were 0.588, 1.839 and 2.229, respectively; in anterior circulation were 0.567, 1.951, 2.198, respectively; in male patients were 0.595, 1.969 and 2.675, respectively; in female patients were 0.573, 1.833 and 1.787, respectively (all P<0.05). Conclusions ASPECTS, DRAGON and SEDAN scales all have strong predictive ability for the risk of hemorrhagic transformation after intravenous thrombolysis in AIS patients, and ASPECTS is superior to the other two prediction models.

Keywords