急性脑梗死静脉溶栓患者NIHSS评分与MESSS评分的应用价值评价

Application of NIHSS and MESSS scoring systems in Acute Cerebral infarctiontreated with intravenous thrombolysis

目的探讨美国国立卫生研究院卒中量表评分(NIHSS)与改良爱丁堡-斯堪的纳维亚评分(MESSS)两种评分量表对急性脑梗死(ACI)患者行重组组织型纤溶酶原激活剂(rt-PA)静脉溶栓的应用价值。方法选取181例行rt-PA静脉溶栓治疗的ACI患者作为研究对象,发病后第90天行改良Rankin量表(m RS)评分,依据评分结果将患者分为预后良好组(93例)和预后不良组(88例),并对2组患者的一般临床资料及发病90 d时的病死率进行观察。结果 (1)2组间在年龄、糖尿病史、溶栓前MESSS评分及NIHSS评分、起病至治疗时间方面的差异均有统计学意义(P<0.05);(2)溶栓不良预后与糖尿病史、溶栓前MESSS评分及N IHSS评分具有相关性(P<0.05);(3)N IHSS评分与MESSS评分评估静脉溶栓后不良的曲线下面积分别为0.874,0.832。结论 N IHSS评分与MESSS评分对ACI患者静脉rt-PA溶栓预后具有较好的预测价值。

Objective To analysis of NIHSS and MESSS scoring systems of application of acute cerebralinfarction （ACI）treated with intravenous thrombolysis by alteplase. Methods 181 patients with ACI treated byrecombinant tissue plasminogen activator（rt-PA）were selected. The patients were evaluated at 90d after attacked bymodified Rankin Scale（mRS）score,and all cases were divided into good prognosis group（n=93）and poor prognosisgroup （n=88） . The clinical data and the mortality at 90d after attacked of two groups were observed and compared.Results ①There were statistically significant differences between the two groups on age,history of diabetes mellitus,MESSS score,NIHSS score and time from attack to treatment. ③The poor prognosis of ACI were as follow： history ofdiabetes mellitus,MESSS score and NIHSS score before thrombolysis;ROC curve analysis revealed that the AUC ofNIHSS and MESSS score to predict poor prognosis was 0.874,0.832. Conclusions NIHSS score and MESSS scorehave a good predictive value in the prognosis of ACI treated with intravenous thrombolysis by rt-PA.