ASTRAL评分、iScore评分对静脉溶栓治疗的急性脑梗死短期预后预测价值

ASTRAL Score and iScore Score in Predicting the Short-term Prognosis of Acute Cerebral Infarction with Intravenous Thrombolysis

目的探讨ASTRAL和iScore评分对静脉溶栓后脑梗死患者短期预后有无预示价值。方法于2016年1—6月选取发病<4.5 h并在该院行静脉溶栓后治疗的AIS患者,所有患者采用ASTRAL、iScore评分进行评估,患者发病3个月时,采用mRS量表对患者的预后进行评估,并根据mRS量表评分的结果将患者分为预后优良组与预后不良组。应用ROC曲线比较各评分系统对患者预后的预测能力,分析ASTRAL、iScore评分与患者预后的关系。结果所有患者ASTRAL和iScore量表的中位得分及四分位数分别为19.4(16.8,23.2)、158(118,228)。其中预后良好组的中位数得分为16.6(14.2~18.8)、87(69.5~111.5);不良预后组的中位得分为178.5(135.75~202.0),预后良好组的中位得分23.9(19.7~30.5)低于不良预后组,差异有统计学意义(P<0.05)。iScore评分的ROC曲线的AUC为0.929,ASTRAL评分(AUC)为0.876),对比差异无统计学意义(Z=1.936,P>0.05),二者预测价值相当。结论ASTRAL、iScore评分可对我国AIS患者静脉溶栓后的短期预后进行预测,二者预测价值相当。

Objective To investigate whether ASTRAL and iScore scores are predictive of short-term prognosis in patients with cerebral infarction after intravenous thrombolysis.Methods From Janaury to June 2016,AIS patients with an onset<4.5h and treated with intravenous thrombolysis in our hospital were selected.All patients were evaluated using ASTRAL and iScore scores.When the patients were 3 months after onset,the mRS scale was used to evaluate the prognosis of the patients.The results of the mRS scale score divided the patients into an excellent prognosis group and a poor prognosis group.The ROC curve was used to compare the predictive ability of each scoring system on the prognosis of patients,and the relationship between ASTRAL and iScore scores and the prognosis of patients was analyzed.Results The median score and quartile of ASTRAL and iScore scales of all patients were 19.4(16.8,23.2)and 158(118,228),respectively.The median score of the good prognosis group was 16.6(14.2-18.8),87(69.5-111.5);the median score of the poor prognosis group was 178.5(135.75-202.0),the good prognosis median score 23.9(19.7-30.5),was lower than the poor prognosis group(P<0.05),the difference was statistically significant.The ROC curve of the iScore score has an AUC of 0.929,and an ASTRAL score(AUC of 0.876).The comparison is not statistically significant(Z=1.936,P>0.05),and the predictive value of the two is equivalent.Conclusion ASTRAL and iScore scores can predict the short-term prognosis after intravenous thrombolysis in AIS patients in China.