| 金迪
，李芹
，吴月霞
，朱慧
，单勇
，刘海超
，王起
，张绿明
，王培福
，杨静 .应用重庆卒中评分预测腔隙性卒中患者短期不良预后风险[J].神经损伤功能重建,2022,17(10):571-574 |
| 应用重庆卒中评分预测腔隙性卒中患者短期不良预后风险 |
| External Validation of Chongqing Stroke Scale to Predict Short-Term Functional Outcomes ofPatients with Lacunar Stroke |
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| DOI： |
| 中文关键词: 腔隙性卒中 早期神经功能缺损进展 预后 受试者工作特征曲线 |
| 英文关键词: lacunar stroke early neurological deterioration prognosis receiver operator characteristic curve |
| 基金项目:航天科工集团医
疗卫生科研项目
（No. 2020-LCYL-
003） |
|
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| 中文摘要: |
| 目的：探讨重庆卒中评分（CQSS）对腔隙性卒中（LS）患者的短期不良预后及早期神经功能缺损进展
（END）的预测价值。方法：前瞻性纳入2020年6月1日至2021年5月31日期间在航天中心医院神经内科住
院的LS患者294例，记录患者基线资料，并进行CQSS评分；主要结局事件为出院时不良预后（改良Rankin
评分≥3分），次要结局事件为出现END；通过受试者工作特征曲线下面积（AUC）判断CQSS对结局事件的
预测价值。结果：根据出院时的mRS评分分为预后不良组58例，预后良好组236例；预后不良组的首次美国
国立卫生院脑卒中量表（NIHSS）评分、首次CQSS评分、CQSS评分增幅均高于预后良好组，且首次CQSS评
分和NIHSS评分之间存在显著的相关性（Pearson系数=0.914，P＜0.001）。CQSS对LS患者在出院时存在不
良预后的风险具有较好的预测意义（AUC=0.760，95%CI 0.692-0.829，P＜0.001），截断值为5分。CQSS评分
对于出现END事件的预测准确度较低（AUC=0.613，95%CI 0.538-0.689，P=0.007）。结论：CQSS评分对LS
患者短期不良结局发生风险预测价值较高，评分越高出现不良预后的风险越大，对于发生END的风险预测
价值一般，需要进一步研究探讨以提高对END事件的预测效能。 |
| 英文摘要: |
| We assessed the efficacy of the Chongqing Stroke Scale (CQSS) for predicting poor
short-term outcome and early neurological deterioration (END) in patients with lacunar stroke. Methods: We
prospectively enrolled 294 LS patients hospitalized in the Neurology Department of Aerospace Center Hospital
from June 2020 to May 2021. Related baseline data were recorded and patients were evaluated by the CQSS. The
main outcome events were defined as poor functional outcome at discharge [modified Rankin scale (mRS) ≥ 3
points]. The secondary outcome events were defined as END. The efficacy of the CQSS in predicting outcome
events was quantified by the area under the Receiver Operating Characteristic curve (AUC). Results: The number of patients with poor prognosis and with good prognosis patients, according to the mRS scores at discharge,
was 58 and 236, respectively. The initial NIHSS score, initial CQSS score, and increase of CQSS score in the
poor prognosis group were higher than those in the good prognosis group, and there was a significant correlation
between the initial CQSS score and NIHSS score (Pearson coefficient=0.914, P<0.001). CQSS had good predictive value for the risk of poor prognosis in LS patients at discharge (AUC=0.760, 95% CI: 0.692-0.829, P<0.001),
with a cut-off value of 5 points. CQSS was less accurate in predicting END events (AUC=0.613, 95% CI:
0.538-0.689, P=0.007). Conclusion: The CQSS score has good predictive value for the risk of short-term adverse outcomes in LS patients, with a higher score indicating a greater risk of poor prognosis. Predictive value of
CQSS for the risk of END is moderate, and further research is needed to improve this aspect. |
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