NIHSS评分对急性脑梗死颅内大动脉闭塞的预测价值

被引：21

作者：

许晓敬 ^{[1
]}

贾阳娟 ^{[1
]}

韩凝 ^{[1
]}

余叶菁 ^{[1
]}

王建华 ^{[2
]}

机构：

[1] 河北医科大学研究生学院

[2] 河北省人民医院神经内科

来源：

脑与神经疾病杂志 | 2016年 / 24卷 / 09期

关键词：

急性脑梗死; NIHSS评分; 动脉闭塞;

D O I：

暂无

中图分类号：

R743.3 [急性脑血管疾病（中风）];

学科分类号：

1002 ;

摘要：

目的探讨急性脑梗死患者NIHSS评分与大动脉闭塞之间的关系,并分析该评分对动脉闭塞是否具有预测价值。方法前瞻性登记急性脑梗死患者211例,其中178例符合入组标准。依据头颅MRA判定大动脉是否闭塞,将患者分为动脉闭塞组及非动脉闭塞组,并应用NIHSS评分评估患者神经功能缺损程度。采用受试者操作特征(ROC)曲线验证NIHSS评分预测动脉闭塞的有效性并确定其最佳截断点。结果头颅MRA显示,动脉闭塞组35例(19.66%),NIHSS评分中位数为3(IQR 2-10),非动脉闭塞组143例(80.34%),NIHSS评分中位数为2(IQR 1-4),动脉闭塞组NIHSS评分明显高于非动脉闭塞组(P<0.05)。ROC曲线结果提示,NIHSS评分预测动脉闭塞的有效性在临床评估时间<6h时较高,曲线下面积为0.829(P<0.05),NIHSS评分最佳截断点为7.5(灵敏度83.3%,特异度95.0%)。临床评估时间超过6h时,NIHSS评分的预测价值下降(P>0.05)。结论 NIHSS评分预测急性脑梗死颅内大动脉闭塞的有效性呈时间依赖性,临床评估时间在发病6h内预测价值较高,随着评估时间的延长而降低。

引用

页码：544 / 548

页数：5

共 9 条

[1]

National Institutes of Health Stroke Scale （NIHSS）[J] . Li Khim Kwah,Joanna Diong.Journal of Physiotherapy . 2014

[2] Validity of the NIHSS in predicting arterial occlusion in cerebral infarction is time-dependent [J].

Olavarria, V. V. ;

Delgado, I. ;

Hoppe, A. ;

Brunser, A. ;

Carcamo, D. ;

Diaz-Tapia, V. ;

Lavados, P. M. .

NEUROLOGY, 2011, 76 (01) :62-68

[3] National Institutes of Health Stroke Scale Score Is Poorly Predictive of Proximal Occlusion in Acute Cerebral Ischemia [J].

Maas, Matthew B. ;

Furie, Karen L. ;

Lev, Michael H. ;

Ay, Hakan ;

Singhal, Aneesh B. ;

Greer, David M. ;

Harris, Gordon J. ;

Halpern, Elkan ;

Koroshetz, Walter J. ;

Smith, Wade S. .

STROKE, 2009, 40 (09) :2988-2993

[4]

Baseline NIH Stroke Scale Score predicting outcome in anterior and posterior circulation strokes[J] . S Sato,K Toyoda,T Uehara,N Toratani,C Yokota,H Moriwaki,H Naritomi,K Minematsu.Neurology . 2008 (24,)

[5]

Guidelines for the Early Management of Adults With Ischemic Stroke: A Guideline From the American Heart Association/American Stroke Association Stroke Council, Clinical Cardiology Council, Cardiovascular Radiology and Intervention Council, and the Atherosclerotic Peripheral Vascular Disease and Quality of Care Outcomes in Research Interdisciplinary Working Groups: The American Academy of Neurology affirms the value of this guideline as an educati[J] . Harold P. Adams,Gregory del Zoppo,Mark J. Al

[6]

The Impact of Recanalization on Ischemic Stroke Outcome: A Meta-Analysis[J] . Joung-Ho Rha,Jeffrey L. Saver.Stroke . 2007 (3)

[7] NIHSS score and arteriographic findings in acute ischemic stroke [J].

Fischer, U ;

Arnold, M ;

Nedeltchev, K ;

Brekenfeld, C ;

Ballinari, P ;

Remonda, L ;

Schroth, G ;

Mattle, HP .

STROKE, 2005, 36 (10) :2121-2125

[8]

CT Angiography in Acute Ischemic Stroke: Preliminary Results[J] . Piero Verro,Lawrence N. Tanenbaum,Neil M. Borden,Souvik Sen,Noam Eshkar.Stroke: Journal of the American Heart Association . 2002 (1)

[9]

Measurements of Acute Cerebral Infarction: A Clinical Examination Scale[J] . Thomas Brott,Harold P. Adams,Charles P. Olinger,John R. Marler,William G. Barsan,José Biller,Judith Spilker,Renee Holleran,Robert Eberle,Vicki Hertzberg,Marvin Rorick,Charles J. Moomaw,Michael Walker.Stroke . 1989 (7)

← 1 →