研究不同脑梗死分型对进展型缺血性脑卒中的影响

Study on the Efects of Different Types of Cerebral Infarction on Progressive Ischemic Stroke

目的:研究不同脑梗死分型对进展型缺血性脑卒中的影响。方法:选择2017年5月至2018年6月在我院接受治疗的急性缺血性脑卒中患者143例,根据病情分为进展组与非进展组,入院时均给予两组患者进行分析,并统计其例数,对分型情况进行单因素分析,挑选进展型缺血性脑卒中的危险因素,进行多因素分析,对有价值因素进行ROC曲线分析。结果:经分析,TOAST分型中LAA、SAO亚型,CT分型中大梗死、中梗死、腔隙梗死;OCSP分型四种亚型以及CISS分型中LAA、PAD、UE亚型组间比较具有统计学意义(P<0.05);经分析,OCSP分型中PACI亚型、TACI亚型,CT分型中大梗死、腔隙性梗死亚型、CISS分型中UE亚型为缺血性脑卒中进展的独立危险因素(P<0.05)。ROC曲线分析显示,PACI亚型、TACI亚型,大梗死、腔隙性梗死亚型、UE亚型预联合检测的ACU下面积明显大单独检测(P>0.05),联合检测的灵敏度、特异度均优于单独检测(P<0.05)。结论:脑梗死分型与进展型缺血性脑卒中之间有密切关系,可预测卒中的进展,且TACI亚型+PACI亚型+UE亚型+腔隙梗死组合模型是预测进展型缺血性脑卒中的最优模型。

Objective:To study the predictive value of different cerebral infarction classification on progressive ischemic stroke.Methods:143 patients of acute cerebral infarction who received therapy from in May 2017 to June 2018 in our hospital were selected as research objects,according to the divided into progression with the progress group,were performed on two groups of patients were analyzed,and the statistics of the number of cases,the single factor analysis of parting,selected from progressive ischemic stroke risk factors,multiple factors analysis,set up different combination,so as to calculate the prediction accuracy.Results:After analysis,LAA and SAO subtypes in TOAST classification,and large infarction,middle infarction and lacunar infarction in CT classification.The comparison between the four subtypes of OCSP and LAA,PAD and UE subtypes of CISS subtypes had statistical significance(P<0.05).After analysis,the CAP scores of PACI subtype,TACI subtype,CT classification,large infarction,lacunar infarction subtype,CISS classification,UE subtype is an independent risk factor for ischemic stroke progression(P<0.05).ROC curve analysis showed that the area under the ACU of PACI subtype,TACI subtype,large infarction,lacunar infarction subtype and UE subtype combined detection was significantly different(P>0.05),sensitivity and specificity of combined detection.Both were better than the individual detection(P<0.05).Conclusion:There is a close relationship between cerebral infarction classification and progressive ischemic stroke,which can predict the progression of stroke,and the combination model of TACI subtype+PACI subtype+UE subtype+lacunar infarction is the optimal model to predict progressive ischemic stroke.