7种评分与急性脑梗死近期预后的相关性研究

Study of the correlation between seven scoring systems and the prognosis in acute cerebral infarction

目的探讨急性生理学和慢性健康状况(APACHEⅡ、APACHEⅢ)评分、改良爱丁堡—斯堪的纳维亚评分(CSS)、美国国立卫生研究所脑卒中评分(NIHSS)、欧洲卒中评分(ESS)、既往史和伴发疾病评分与急性脑梗死患者预后的关系。方法对441例急性脑梗死患者在入院24 h内分别进行APACHEⅡ、APACHEⅢ、CSS、NIHSS、ESS、既往史和伴发疾病评分,根据患者发病后1个月时的预后分为生存组和死亡组,并对各组各评分进行统计分析。结果 APACHEⅡ、APACHEⅢ、CSS、NIHSS和伴发疾病评分分值死亡组高于生存组,ESS评分死亡组低于生存组(P均<0.01)。既往史评分生存组和死亡组无统计学意义。多因素Logistic回归分析显示,APACHEⅡ、A-PACHEⅢ、NIHSS、ESS和伴发疾病评分为急性脑梗死预后的影响因素(P均<0.05)。结论 APACHEⅡ、APACHEⅢ、NIHSS、ESS和伴发疾病评分对急性脑梗死患者的预后有较好的预测价值。

Objective To investigate the relationship between APACHEⅡ,APACHEⅢ,CSS,NIHSS,ESS,complication scale,past history scale and the prognosis in acute cerebral infarction.Methods A total of 441 patients with acute cerebral infarction were tested with APACHEⅡ,APACHEⅢ,CSS,NIHSS,ESS and complication scale after 24 hours admission.All of them were divided into two groups according to the status of survival or death after 1 month of morbility.Results A significant difference was found between survivors and non-survivors group on the score of patients scored by APACHEⅡ,APACHEⅢ,NIHSS,CSS,ESS and complication scale respectively（P0.01）.The scores of non-survivors group were higher than those of survivors group by APACHEⅡ,APACHEⅢ,NIHSS,CSS and complication scale,and lower than that of survivors group by ESS（P0.05）.The scale of past history had no significant difference between survivors and non-survivors group（P0.05）.Logistic multivariate regression results showed that APACHEⅡ,APACHEⅢ,NIHSS,ESS and complication scale were all significantly associated with early prognosis of acute cerebral thrombosis.Conclusion APACHEⅡ,APACHEⅢ,NIHSS,ESS and complication scale are superior to the others in predicting the status of survival or death of acute cerebral thrombosis.