ROC分析卒中早期各因素对预测PSD的价值

The Value of ROC Analysis of Factors in Early Stage on Predicting PSD

目的对缺血性卒中早期各相关因素及中医证侯要素的演变进行初步的研究,从中医证素角度早期预测卒中后抑郁(PSD)的发生。方法回顾性调查研究急性缺血性卒中患者,研究首发急性缺血性中风患者的中医证候要素的动态演变规律及与PSD发生之间的关系,寻找可能促成PSD发生的危险因素。结果通过ROC分析中医证候要素对早期预测PSD的价值可知,发病初期的痰证积分>9.5分,血瘀积分>13.5分的患者其以后发生PSD事件可能性较大。到14 d时通过痰湿、血瘀、气虚等证素预测PSD灵敏度及特异度均较好。结论动态观察急性缺血性卒中患者中医证候要素演变,尤其对疾病发展过程中痰湿、血瘀、气虚证明显的患者积极做好PSD的二级预防工作,减少PSD事件的发生。

Objective： Focused on preliminary investigation of relevant factors in early stage of ischemic stroke and TCM syndrome elements evolution so as to predict the occurrence of PSD in view of TCM syndrome. Meth- ods： Dynamic evolution of TCM syndrome elements of acute ischemic stroke patients and their relations to PSD were retrospectively studied and the risk factors which may induce to PSD were investigated. Results： Through the value of ROC analysis of TCM syndrome factors predicting PSD ,phlegm syndrome score higher than 9.5 and blood stasis syndrome score higher than 13.5 proved higher incidence of PSD. After 14 days,syndrome factors such as phlegm-damp, blood stasis and Qi deficiency had good predictive sensitivity and specificity. Conclusion： Clinicians shall dynamically observe the development of syndrome factors in patients, especially for patients with syndromes evolution of phlegm, blood stasis and Qi deficiency. PSD secondary prevention work shall be prepared for such patients in order to reduce PSD in advance.