首发缺血性卒中患者短期预后评价模型

The short-term prognosis evaluation model for the first ischemic cerebral stroke patients

目的:探索首发缺血性卒中患者急性期神经功能缺损程度的影响因素,建立短期预后评价模型。方法:选择2014年9月至2015年12月在郑州大学第五附属医院住院的89例首发急性脑梗死患者,采用统一设计的问卷收集基本资料,美国国立卫生院神经功能缺损评分量表(NIHSS)评价神经功能缺损程度,改良Rankin量表(m RS)评价3个月后预后。结果 :轻、中、重3组在年龄等传统危险因素方面无差异;WBC等6种血液学指标与NIHSS评分(P<0.05)及预后评分(P<0.05)均相关;D-二聚体等6种血液学指标及基线NIHSS评分对预后有显著影响(OR=1.800、0.976、1.112、1.327、5.564、6.456、1.227);ROC曲线下面积为0.976,模型预测价值较好。结论:传统危险因素无差异的不同神经缺损程度的缺血性卒中患者中,D-二聚体等6种血液学指标及NIHSS评分对预后有显著影响,模型能较为准确地预测缺血性脑卒中的短期预后情况。

Objective To explore common risk factors of the first acute ischemic cerebral stroke patients′neurological deficits and build a short-term prognosis model. Methods 89 hospitalized patients with acute is-chemic cerebral stroke were chosen for study from September 2014 to December 2015 in the Fifth Affiliated Hos-pital of Zhengzhou University. Our study′s evaluation methods were using the unified questionnaires , the NIHSS score and the mRS scale. Results Traditional risk factors were no significant difference among the three groups （P 〉 0.05）; 6 kinds of hematology indexes such as WBC count had significant difference in NIHSS score （P 〈0.05） and prognosis（P 〈 0.05）; 6 kinds of hematology indexes such as D-D and the NIHSS score had a signifi-cant effect on prognosis （OR = 1.800, 0.976, 1.112, 1.327, 5.564, 6.456, 1.227）; the area under ROC curve was 0.976, which proved the model had a good predictive value. Conclusion Traditional risk factors had no significant difference among the different neurological deficits groups; 6 kinds of hematology indexes such as D-D and NIHSS score on admission had a significant influence on prognosis; the model predicted the short-term prognosis of acute ischemic cerebral stroke more accurately.