ESRS评分联合磁共振血管成像对前循环急性脑梗死患者复发风险的预测价值

Predictive value of ESRS scoring combined with magnetic resonance angiography in the risk of recurrence in patients with anterior circulation acute cerebral infarction

目的评价Essen卒中风险评分量表(ESRS)评分联合磁共振血管成像(MRA)对前循环急性脑梗死(ACI)患者复发风险的预测价值。方法选择本院神经科2016年前循环ACI住院患者156例,根据ESRS评分分为高危组65例,低危组91例。根据MRA检查结果分为颅内血管狭窄率≥50%者75例和狭窄率<50%者81例,比较各组发病后第1个月、第3个月和第6个月ACI的发生情况,绘制受试者工作特征曲线(ROC曲线),以评价ESRS评分联合MRA对ACI患者卒中复发风险的预测价值。结果 ESRS高危组在发病后第1个月、第3个月、第6个月ACI的发生率均高于低危组(P<0.05);颅内血管狭窄率≥50%的患者,在发病后第1个月、第3个月、第6个月ACI的发生率均高于颅内血管狭窄<50%的患者(P<0.05);ESRS评分联合MRA预测ACI发生后第1月、第3月和第6月复发脑梗死的曲线下面积(AUC)均高于单纯ESRS评分(P<0.05)。结论 ESRS评分联合MRA能进一步提高预测ACI患者卒中复发的准确率,且预测价值较高。

Objective To evaluate the predictive value of Essen stroke risk scale （ ESRS ） score and magnetic resonance angiography （ MRA ） in the risk of recurrence in patients with anterior circulation acute cerebral infarction （ ACI ） . Method One hundred and fifty-six patients with acute anterior circulation cerebral infarction from our department of Neurology in 2016 were divided into high risk group （ sixty-five cases ） and low risk group （ ninety-one cases ） according to ESRS score. According to MRA results thy were divided into intracranial stenosis rate /〉 50% （ seventy-five cases ） and stenosis rate 〈50% （ eighty-one cases ） . The incidence of ACI was compared between the first month, the third month and the sixth month after the onset of each group.ROC curve was drawn to evaluate the predictive value of ESRS score combined with MRA in the risk of stroke recurrence in patients with cerebral infarction. Results The incidence of cerebral infarction in the high risk group of ESRS was higher than that in low risk group in the first, third and sixth months after onset （ P〈0.05 ） . Patients with intracranial vascular stenosis 1〉 50% had a higher incidence of cerebral infarction than that with intracranial vascular stenosis 〈50% in the first, third, and sixth months after onset （ P〈0.05 ） . ESRS score combined with MRA used to predict the area under the curve of cerebral infarction （ AUC ） in the first, third and sixth months after cerebral infarction was higher than that of ESRS alone （ P〈0.05 ） . Conclusion ESRS scoring combined with MRA can further improve the accuracy of predicting the recurrence of stroke in patients with cerebral infarction, and the predictive value is higher.