ESSEN和SPI-Ⅱ量表预测脑卒中长期复发

Role of ESSEN and SPI-Ⅱscores in predicting the long-term recurrent rate of ischemic stroke

目的验证ESSEN和SPI-Ⅱ评分量表预测脑卒中长期复发风险的效力。方法选择非心源性急性脑梗死患者209例,用电话随访结合电子病历查询方法,分为单发组119例和复发组90例,分别用ESSEN和SPI-Ⅱ量表进行评分,计算2种量表ROC曲线下面积(AUC)。用Kaplan-Meier生存曲线分析患者5年生存率。结果与单发组比较,复发组ESSEN评分[(2.54±1.15)分vs(1.89±1.09)分]和SPI-Ⅱ评分[(7.78±1.81)分vs(6.82±1.69)分]明显升高(P=0.000)。ESSEN评分的AUC为0.656,SPI-Ⅱ评分的AUC为0.652。ESSEN评分低危组患者5年生存率较高危组升高(65.6%vs 43.8%,P=0.002),SPI-Ⅱ评分低危组患者较中危组和高危组5年生存率明显升高(72.4%vs 43.8%和42.9%,P=0.000,0.030)。结论 ESSEN和SPI-Ⅱ评分预测急性脑卒中患者5年的脑卒中复发有相似预测效力,应用2个量表预测中国人脑卒中的5年复发率是可行的。

Objective To validate the role of ESSEN and SPI-Ⅱ scores in predicting the long-term recurrent rate of ischemic stroke.Methods Two hundred and nine cardiogenic acute ischemic stroke patients admitted to our hospital from 2005 to 2007 were divided into solitary recurrent group （n=119） and recurrent group （n=90）.Their ESSEN and SPI-Ⅱ scores were recorded.The area under the AUC was measured.Their 5-year survival rate was analyzed by Kaplan-Meier analysis.Resuts The AUC was 0.656 according to the ESSEN score and was 0.652 according to the SPI-Ⅱ score.The 5-year survival rate was significantly higher in low risk group than in high risk group according to the ESSEN score （65.6％ vs 43.8％,P=0.002）,and in low risk group than in moderate and high risk group according to the SPI-Ⅱ score （72.4 ％ vs 43.8 ％,P =0.000 ; 72.4 ％ vs 42.9 ％,P=0.030）.Conclusion The role of ESSEN and SPI-Ⅱ scores is similar in predicting the 5-year recurrent rate of ischemic stroke in Chinese acute ischemic stroke patients.