缺血性脑卒中不同分型的比较及临床应用价值的探讨

目的探讨缺血性脑卒中患者OCSP分型和TOAST分型在判断患者的病情和预后方面的临床应用价值。方法对入选的520例缺血性脑卒中患者于入院时和出院时分别进行OCSP和TOAST分型;再分别评定不同分型患者入院和出院时的神经功能缺损,随访1个月。结果在TOAST分型中,以SAO最常见;CE入院时神经功能缺损评分最高;出院时再次分型,一致率为63.8%。在OCSP分型中,以LACI最常见;TACI病因最常见于LAA,PACI病因较常见于SAO、SUE和LAA,POCI病因较常见于SUE和LAA,LACI病因最常见于SAO;TACI入院时神经功能缺损评分最高;OCSP分型与最终神经影像学诊断一致率为89.6%。结论OCSP分型与神经影像学诊断具有较高的一致性;TOAST分型可准确反映病因。

Objective To evaluate the clinical practical value of ischemic stroke subtypes according to the OCSP and TOAST criteria on judging the patients, condition and prognosis of the acute ischemic stroke. Methods Five hundred and twenty inpatients were classified into different subtypes according to the OCSP and TOAST criteria when they were on admission and leaving hospital. And neurological impairment of the all subtypes were evaluated respectively. Results According to TOAST criteria, the frequency was highest in SAO, CE inpatients have the highest neurological impairment score on admission; 63.8% patients, OCSP classification was consistent with the last image diagnose. According to OCSP criteria, the frequency was highest in LACI; LAA was the most common cause in TACI, SAO, SUE and LAA was found in PACI, SUE and LAA was the main etilogical cause in POCI;SAO was the most common cause in LACI; in OCSP, TACI inpatients had the highest neurological impairment score; there were 89.6% patients whose OCSP classification was consistent with the last image diagnose. Conclusion The OCSP classification has the high consistency with the neurological image; the TOAST classification can predict the exact cause of diseases finally.