两种评分用于识别急性缺血性脑卒中患者中类卒中的有效性研究

Validation of TM score and sFABS score in recognizing stroke mimics in patients with acute ischemic stroke

目的 探讨远程卒中模拟病(TM)评分和改良简化版急诊室类卒中筛查(sFABS)评分在急诊条件下用于识别急性缺血性脑卒中(AIS)患者中类卒中的有效性。方法 选择2020年1月~2021年12月我院卒中中心实施静脉溶栓和(或)血管内治疗患者94例,根据影像学检查分为AIS组83例和类卒中组11例。收集患者一般临床资料,用ROC曲线分析。结果 类卒中组美国国立卫生研究院卒中量表(NIHSS)评分、TM评分、NIHSS评分>14分及面瘫比例明显低于AIS组,sFABS评分明显高于AIS组(P<0.01)。TM评分预测类卒中的ROC曲线下面积(AUC)为0.967(95%CI:0.933~1.000,P<0.01),sFABS评分的AUC为0.875(95%CI:0.773~0.977,P<0.01)。结论 2种评分对类卒中具有良好的识别能力,可以为溶栓或介入治疗前识别类卒中患者提供参考。

Objective To investigate the validities of telestroke mimic(TM) score and simplified FABS scale(sFABS) in identifying stroke mimics(SM) in patients with acute ischemic stroke(AIS) in emergency.Methods A total of 94 consecutive patients who received intravenous thrombolysis and/or endovascular therapy in the Stroke Center of the General Hospital of Western Theater Command from January 2020 to December 2021 were recruited in this study.According to imaging examinations, they were divided into AIS group(83 cases) and SM group(11 cases).Their general data were collected.ROC curve analysis was performed.Results The SM group had significantly lower NIHSS score, TM score, and proportions of those with NIHSS score >14 and facial paralysis, but higher sFABS score than the AIS group(P<0.01).ROC curve analysis showed the AUC value of TM score in predicting SM was 0.967(95%CI:0.933-1.000,P<0.01),while that of sFABS score was 0.875(95%CI:0.773-0.977,P<0.01).Conclusion The two scales have good recognition ability for SM,which can provide reference for identifying SM patients before thrombolytic or interventional treatment.