CT血管造影点征对早期脑出血手术治疗及预后的评估作用研究

Study on Evaluated Effects of Dot Signs of CT Angiography on Surgical Treatment and Prognosis of Early Cerebral Hemorrhage

目的探讨早期脑出血患者CT血管造影(CTA)点征评分预测血肿扩大及预后的评估效能。方法回顾性分析84例早期脑出血患者临床资料,根据起病24h内血肿扩大情况分为扩大组(n=26)与未扩大组(n=58),根据起病后3个月神经功能恢复情况[改良Rankin量表(mRS)评分]分为不良组(mRS≥3分,n=29)与良好组(mRS≤2分,n=55),比较不同分组条件下两组患者CT A点征评分差异,以受试者工作特征(ROC)曲线分析CTA点征对早期脑出血患者血肿扩大及预后的预测效能。结果扩大组CTA点征评分明显高于未扩大组(P<0.05),不良组CTA点征评分也明显高于良好组(P<0.05)。CTA点征预测血肿扩大及预后神经功能恢复的ROC曲线AUC分别为0.736(0.619~0.854)、0.786(0.684~0.888),与对角参考线AUC比较均有统计学意义(P<0.05),其敏感度分为别69.23%、72.41%,特异性分别为74.14%、78.18%。结论CTA点征能有效预测血肿扩大,为早期脑出血患者提供手术治疗指征,并评估预后神经功能恢复潜能,有利于尽早采取对应干预措施加以改善。

Objective To explore the evaluated efficacy of dot signs scores of CT angiography(CTA)in predicting hematoma enlargement and prognosis in patients with early cerebral hemorrhage.Methods The clinical data of 84 patients with early cerebral hemorrhage were retrospectively analyzed.According to hematoma enlargement within 24h of onset,the patients were divided into enlargement group(n=26)and nonenlargement group(n=58).According to the neurological recovery at 3 months after onset[modified Rankin scale(mRS)score],the patients were divided into poor group(mRS≥3 points,n=29)and good group(mRS≤2 points,n=55).The scores of CTA dot signswere compared between the two groups of patients under different grouping conditions.The predictive efficacy of CTA dot signs on hematoma enlargement and prognosis in patients with early cerebral hemorrhage was analyzed by receiver operating characteristic(ROC)curves.Results The scores of CTA dot signs in enlargement group were significantly higher than those in non-enlargement group(P<0.05),and the scores of CTA dot signs in poor group were also significantly higher than those in good group(P<0.05).The AUC values of ROC curves of CTA dot signs in prediction of hematoma enlargement and prognosis of neurological function recovery were 0.736(0.619-0.854)and 0.786(0.684-0.888)respectively,which were statistically significantly different compared with the diagonal reference line AUC(P<0.05),and their sensitivities were 69.23% and 72.41%,and the specificities were 74.14% and 78.18%respectively.Conclusion CTA dot signs can effectively predict hematoma enlargement,provide indications for surgical treatment of patients with early cerebral hemorrhage,and evaluate the prognosis of neurological recovery potential,and it is conducive to early intervention measures to improve.