术前熵指数与急性脑卒中介入手术患者病情严重程度的相关性分析

Correlation between preoperative entropy index and severity of acute stroke patients undergoing interventional surgery

目的分析急性脑卒中介入手术患者术前熵指数与病情严重程度的相关性。方法采用前瞻性研究方法,选择急性脑卒中介入手术患者71例,在术前测定所有患者的反应熵(response entropy,RE)和状态熵(state entropy,SE)。术前根据美国国立卫生研究院卒中量表(National Institute of Health Stroke Scale,NIHSS)评分将患者分为病情较轻组(M组,47例,NIHSS≤15分)和病情较重组(S组,24例,15分<NIHSS≤42分)。比较两组患者的术前熵指数,RE、SE与NIHSS评分采用二元Logistic回归分析,绘制受试者工作特征(receiver operator characteristic,ROC)曲线,计算曲线下面积。结果71例患者均纳入最终分析,M组患者术前RE和SE大于S组(P<0.05);二元Logistic回归分析显示RE、SE与患者病情严重程度呈负相关;ROC曲线显示RE评估急性脑卒中患者病情的ROC曲线下面积(area under curve,AUC)为0.858,当最佳截断值为67.5时,约登指数最大(0.666);SE判断急性脑卒中患者病情的AUC为0.843,最佳截断值为59时,约登指数最大(0.666)。结论术前熵指数与脑卒中患者病情严重程度呈负相关,可作为急性脑卒中介入手术患者病情评估的较敏感指标之一。

Objective To analyze the correlation between preoperative entropy index and severity of acute stroke patients undergoing interventional surgery.Methods A prospective study was conducted,where 71 acute stroke patients undergoing interventional surgery were selected.Before surgery,their response entropy(RE)and state entropy(SE)were measured.Before surgery,according to the National Institute of Health Stroke Scale(NIHSS),the patients were divided into two groups:a mild group(group M,n=47,NI-HSS≤15 points)and a serious group(group S,n=24,15 points<NIHSS≤42 points).The preoperative entropy index of the two groups was compared.The RE,SE and NIHSS scores were analyzed by binary Logistic regression analysis,and the receiver operator characteristic(ROC)curve was drawn to calculate the area under the curve(AUC).Results All the 71 patients were included in the final analysis.Patients in group M presented with significantly higher preoperative RE and SE than those in group S(P<0.05).Binary logistic regression analysis showed that RE and SE were negatively correlated with the severity of patient's condition.The ROC curve showed that the AUC of RE for assessment of acute stroke patients was 0.858,and when the optimal cutoff value was 67.5,the Yoden index was the largest(0.666).The AUC of SE for determination of acute stroke patients was 0.843,when the optimal cutoff value was 59,the Yoden index was the largest(0.666).Conclusions Preoperative entropy index is negatively correlated with the severity of stroke patients,which can be used as one of the sensitive indicators for assessment of acute stroke patients undergoing interventional surgery.