摘要
目的 探讨“九分法”在预测原发性脑出血患者血肿扩大及不良临床预后中的价值。方法 选择79例自发性脑出血患者按照“九分法”评分后,分为0~3分组55例和4~9分组24例。采用CT血管造影（CTA）原始图像中寻找“点征”以及基线CT平扫血肿体积计算,比较2组基线资料、美国国立卫生研究院卒中量表（NIHSS）、血肿扩大、外科手术干预及死亡人数,同时比较“九分法”与单纯使用“点征”预测血肿扩大的优劣。结果 与0~3分组比较,4~9分组点征阳性、复查血肿扩大、30dNIHSS评分、外科手术干预、90d病死率明显升高,差异有统计学意义（P〈0.05,P〈0.01）。“九分法”预测血肿扩大阳性预测值为50.0%,阴性预测值为96.4%,敏感性85.7%,特异性81.5%。与单纯使用“点征”预测比较,“九分法”预测血肿扩大阳性预测值下降,阴性预测值升高。结论 “九分法”能够有效预测血肿扩大及不良临床预后,在临床运用中应结合“九分法”对脑出血患者进行分层治疗。
Objective To study the value of ＂nine points method＂ in predicting hematoma expan sion and its adverse clinical outcome in primary cerebral hemorrhage patients. Methods Seventynine spontaneous cerebral hemorrhage patients were divided into 0--3 scores group （n=55） and 4--9 scores group （n = 24）. The＂spot sign＂on CTA was searched and the baseline CT-scanned he- matoma volume was measured. The baseline data, NIHSS score, hematoma volume, number of surgery-intervened patients, and their mortality were compared. The advantages and disadvantages of＂nine points method＂and＂spot sign＂ in predicting hematoma volume were also compared. Results The positive＂spot sign＂rate,hematoma expansion volume,30 d NIHSS score,number of surgery intervened patients and their 90 d mortality were significantly higher in 4--9 scores group than in 0--3 scores group （P〈0.05,P〈0.01）. The positive predictive and negative valuve of ＂nine points method＂was 50.0% and 96.4% respectively with a sensitivity of 85.7% and a specificity of 81. 5%. The positive prediction value of ＂nine points method＂was lower than that of ＂spot sign＂while the negative prediction value of ＂nine points method＂was higher than that of ＂spot sign＂. Conclusion ＂Nine points method＂ can effectively predict hematoma expansion and its adverse clinical outcome and can thus be used in treatment of cerebral hemorrhage patients.
出处
《中华老年心脑血管病杂志》
CAS
2015年第2期158-160,共3页
Chinese Journal of Geriatric Heart,Brain and Vessel Diseases
基金
天津市卫生局科技基金(2013KZ002)
