两种CT血管造影侧支循环评分对大脑中动脉闭塞性脑卒中患者预后的评价价值研究

The Value of Two CT Angiographic Collateral Circulation Scores in the Evaluation of Prognosis in Patients with Middle Cerebral Artery Occlusion Stroke

目的分析两种CT血管造影(CTA)侧支循环评分(Maas、Tan)对大脑中动脉闭塞(MCAO)性脑卒中患者预后的评价价值。方法选择2018年1月—2020年4月江苏省无锡市锡山人民医院接收的MCAO性脑卒中患者68例,按美国国立卫生研究院卒中量表(NIHSS)评分分为两组,NIHSS评分<16分的预后较好组(36例),NIHSS评分≥16分的预后较差组(32例)。两组均于发病12 h内完成CTA侧支循环评分评估并通过磁共振弥散加权成像(DWI)计算闭塞梗死体积,通过多因素Logistic回归分析MCAO性脑卒中患者预后不良的影响因素,评估两种CTA侧支循环评分与DWI梗死面积对MCAO性脑卒中患者预后的预测价值。结果预后较好组Maas和Tan评分高于预后较差组,DWI可见闭塞梗死体积小于预后较差组(P<0.05);预后较差的影响因素有Maas≥3分、Tan≥2分及DWI梗死体积≥30.2 cm2(P<0.05);Maas评分灵敏度、特异度分别为75.00%、62.50%,Tan评分灵敏度、特异度分别为77.78%、71.88%,DWI梗死体积灵敏度、特异度分别为100.00%、75.00%。结论将Maas、Tan评分应用于MCAO性脑卒中患者中均可有效评估患者预后,且Tan评分的灵敏度及特异度较Maas均明显更高,在评价患者预后价值方面更具优势。

Objective To analyze the prognostic value of two KINDS of CT angiography(CTA)collateral circulation scores in patients with middle cerebral artery occlusion(MCAO)stroke.Methods 68 patients with MCAO stroke admitted to our hospital from January 2018 to April 2020 were selected,and the patients were divided into two groups according to the NATIONAL Institutes of Health Stroke Scale(NIHSS)score.36 patients with a NIHSS score<16 had a good prognosis,and 32 patients with a NIHSS score≥16 had a poor prognosis.CTA collateral circulation score was evaluated within 12 h of onset in both groups,and the volume of occlusive infarction was calculated by diffusion-weighted magnetic resonance imaging(DWI),and multivariate Logistic regression was used to analyze the influencing factors of poor prognosis in PATIENTS with MCAO stroke,to evaluate the prognostic value of two CTA collateral circulation scores and DWI infarction area in patients with MCAO stroke.Results The Maas and Tan scores of the group with good prognosis were higher than that of the group with poor prognosis,and the volume of visible occlusion infarction on DWI was smaller than that of the group with poor prognosis(P<0.05).The influencing factors of poor prognosis include Maas≥3 points,Tan≥2 extension,DWI infarction volume≥30.2 cm2(P<0.05).The sensitivity and specificity of Maas score were 75.00%and 62.50%,the sensitivity and specificity of Tan score were 77.78%and 71.88%,and the volume sensitivity and specificity of DWI infarction were 100.00%and 75.00%,respectively.Conclusion The application of Maas and Tan scores in patients with MCAO stroke can effectively evaluate the prognosis of patients,and the sensitivity and specificity of Tan scores are significantly higher than those of Maas,which is more advantageous in the evaluation of the prognostic value of patients.