ABCD2评分及ESRS评分对急诊神经内科头晕患者发生缺血性脑卒中的诊断预测价值

Value of ABCD2 and ESRS scoring systems in predicting and diagnosis of acute ischemic stroke in dizziness patients in emergency neurology department

目的探讨ABCD2评分及Essen卒中风险评分量表(ESRS)对于急诊神经内科以头晕为主诉患者发生急性缺血性脑卒中的诊断预测价值。方法选取因头晕就诊的患者共260例,分别应用ABCD2量表及ESRS量表进行评分。ABCD2评分分组为低危组(138例,0~3分)、中危组(101例,4~5分)和高危组(21例,6~7分)。ESRS评分分组为低危组(158例,0~2分)、中危组(97例,3~6分)和高危组(5例,7~9分),对所有患者进行头CT和头颅MRI检查。结果共发生急性缺血性脑卒中65例,其中ABCD2评分低危组9例(6.52%),中危组40例(39.60%),高危组16例(76.1%);ESRS评分低危组3例(1.90%),中危组58例(59.79%),高危组4例(80%)。脑卒中组与未发生脑卒中组在年龄、ABCD2评分、ESRS评分、高血压、糖尿病、吸烟史、冠心病史、脑卒中史等方面均有显著差异(P<0.01)。多因素Logistic回归分析显示,ABCD2评分、Essen评分、糖尿病史及卒中史是预测急诊神经内科头晕患者发生缺血性脑卒中的独立预测因素。结论ABCD2评分和ESRS评分均可以作为预测急诊神经内科头晕患者发生缺血性脑卒中的独立预测因素。ABCD2评分优于ESRS评分。

Objective To explore the value of ABCD2 and ESRS scoring systems for predicting and diagnosis of acute ischemic stroke in dizziness patients in emergency neurology department.Methods A total of 260 patients with dizziness in our emergency department were evaluated by ABCD2 and ESRS scoring systems. Patients with ABCD2 score system were divided into low risk group（ 138 cases,0 ～ 3 points）,middle risk group（ 101 cases,4 ～ 5 points） and high risk group（ 21 cases,6 ～ 7 points）. Patients with ESRS score were divided into low risk group（ 158 cases,0 ～2 points）,middle risk group（ 97 cases,3 ～ 6 points） and high risk group（ 5 cases,7 ～ 9 points）.All the patients implemented brain computed tomography（ CT） and magnetic resonance imaging（ MRI）. Results There were 65 cases（ 25. 00%） with acute ischemic stroke,and 9（ 6. 52%） in low risk group of ABCD2 score system,40（ 39. 60%） in middle risk group,and 16（ 76. 1%） in high risk group. And were 3（ 1. 90%）,58（ 59. 79%）,and 4（ 80. 00%）,respectively,in groups by ESRS scoring system. The differences in ABCD2 scores and ESRS scores,history of hypertension,age,history of diabetes,history of coronary heart disease,history of stroke,history of smoke between the stroke group and non-stroke group were statistically significant（ P〈0. 01）. Multivariate logistic regression analysis showed that ABCD2 and ESRS scores,history of diabetes,history of stroke were independent factors in predicting ischemic stroke in dizziness patients. Conclusion Both ABCD2 and ESRS scoring systems can be independent factors in predicting ischemic stroke in dizziness patients in emergency department,and ABCD2 scoring system is better than ESRS scoring system.