前后循环梗死评分系统:1种评估急性缺血性卒中患者预后的新方法

Anterior and posterior circulation infarction image score(APCIIS),a novel approach to evaluate the prognosis of patients with acute ischemic stroke

目的:开发并验证一种新型急性缺血性脑卒中(acute ischemic stroke,AIS)评分系统-前后循环梗死评分系统(anterior and posterior circulation infarction image score,APCIIS)。方法:回顾性分析2020年6月至2021年6月在重庆医科大学附属第一医院收治的163例急性缺血性卒中患者的临床资料。将患者分为前循环AIS组(n=109)及后循环AIS组(n=54)。利用单因素和多因素分析影响前循环AIS及后循环AIS患者预后情况的危险因素。以血栓负荷评分(the clot burden score,CBS)及基底动脉闭塞评分(the basilar artery on computed tomography angiography score,BATMAN)为参考,绘制受试者工作特征曲线,分析该新型评分(APCIIS)预后评估的价值。结果:在前循环AIS组,APCIIS的预后评估价值虽然未能优于CBS,但显示出相对更高的敏感度86.8%、特异度90.1%及曲线下面积0.939。在后循环AIS组,APCIIS的预后价值优于BATMAN评分。结论:APCIIS是预测急性缺血性脑卒中患者预后的1种方便可靠的办法。

Objective:Development and validation of a novel acute ischemic stroke(AIS)scoring system:Anterior and posterior circu⁃lation infarction image score(APCIIS).Methods:Retrospective analysis of clinical data from 163 patients with acute ischemic stroke admitted to the First Affiliated Hospital of Chongqing Medical University from 2020/6 to 2021/6.The patients were divided into ante⁃rior circulation AIS group(n=109)and posterior circulation AIS group(n=54).Univariate and multivariate analyses were performed to identify risk factors affecting the prognosis of patients with AIS.Using the Clot Burden Score(CBS)and the Basilar Artery on Com⁃puted Tomography Angiography score(BATMAN)as references,receiver operating characteristic(ROC)curves were plotted to analyze the predictive value of the novel scoring system(APCIIS)for prognosis assessment.Results:In the anterior circulation AIS group,although the prognostic value of APCIIS was not superior to CBS,it demonstrated relatively higher sensitivity of 86.8%,specificity of 90.1%,and an area under the curve of 0.939.In the posterior circulation AIS group,APCIIS showed better prognostic value than the BATMAN score.Conclusion:APCIIS is a convenient and reliable method for predicting the prognosis of patients with AIS.