四种评分系统对缺血性脑卒中相关性肺炎的预测价值比较

doi:10.3969/j.issn.1006-9771.2018.06.014

《中国康复理论与实践》 ›› 2018, Vol. 24 ›› Issue (6): 696-701.doi: 10.3969/j.issn.1006-9771.2018.06.014

四种评分系统对缺血性脑卒中相关性肺炎的预测价值比较

王娜,刘芦姗,王丰容

中国康复研究中心北京博爱医院急诊科,北京市100068

收稿日期:2018-03-30 修回日期:2018-04-16 出版日期:2018-06-25 发布日期:2018-06-28
通讯作者: 王娜。E-mail: wangnaxxyy@163.com
作者简介:王娜(1977-),女,汉族,河北安国市人,博士研究生,主治医师,主要研究方向：危重症。

Comparison of Four Scoring Systems in Predicting Risk of Stroke-associated Pneumonia in Patients with Acute Ischemic Stroke

WANG Na, LIU Lu-shan, WANG Feng-rong

Emergency Department, Beijing Bo'ai Hospital, China Rehabilitation Research Center, Beijing 100068, China

Received:2018-03-30 Revised:2018-04-16 Published:2018-06-25 Online:2018-06-28
Contact: WANG Na. E-mail: wangnaxxyy@163.com

摘要/Abstract

摘要： 目的比较ISAN评分、A2DS2评分、急性缺血性卒中相关性肺炎评分(AIS-APS)以及PANTHERIS评分对卒中相关性肺炎(SAP)的预测价值。方法回顾分析2014年4月至2017年12月本院急诊病房收治的急性缺血性脑卒中患者338例,将其分为SAP组(n=125)和非SAP组(n=213),应用受试者工作特征(ROC)曲线分析评价四种评分系统对SAP的预测作用。结果急诊病房中SAP发生率为37.0%,SAP组与非SAP组患者在年龄、并发症(房颤、冠心病和脑卒中)、格拉斯哥昏迷评分(GCS)、美国国立卫生研究院卒中量表(NIHSS)评分、ISAN评分、A2DS2评分、AIS-APS评分以及PANTHERIS评分方面有显著性差异(P<0.05)。PANTHERIS评分的A值(0.818)最小,与AIS-APS评分、A2DS2评分和ISAN评分比较有显著性差异(P<0.05),ISAN评分和A2DS2评分比较无显著性差异(P>0.05)。结论 ISAN评分、A2DS2评分和AIS-APS评分均能有效预测急诊病房急性缺血性脑卒中患者SAP的发生。但由于AIS-APS评分计算相对复杂,建议急诊工作者采用ISAN评分和A2DS2评分预测脑卒中患者SAP的发生。

关键词: 急性缺血性脑卒中, 卒中相关性肺炎, ISAN评分, A2DS2评分, 急性缺血性卒中相关性肺炎评分, PANTHERIS评分

Abstract: Objective To compare the performance of Prestroke Independence, Sex, Age, National Institutes of Health Stroke Scale (ISAN) score, Age, Atrial fibrillation, Dysphagia, Sex, Stroke Severity (A2DS2) score, acute ischemic stroke-associated pneumonia score (AIS-APS), and Preventive ANtibacterial THERapy in Acute Ischemic Stroke (PANTHERIS) score in predicting the risk of stroke-associated pneumonia (SAP).Methods The baseline characteristics and laboratory data of 338 patients with ischemic stroke in emergency ward from April, 2014 to December, 2017 were retrospectively analyzed. Patients were allocated into SAP group (n=125) and non-SAP group (n=213). Receiver operating characteristic curve (ROC) was used to evaluate the predictive effect of four different scoring systems for ischemic SAP.Results Totally, 125 (37.0%) patients developed SAP. There were significant differences in age, complications (atrial fibrillation, coronary heart disease and history of stroke), Glasgow Coma Scale (GCS) score, National Institute of Health Stroke Scale (NIHSS) score, ISAN score, A2DS2 score, AIS-APS score and PANTHERIS score between two groups (P<0.05). The A value of PANTHERIS score was 0.818, which was the lowest among four scoring systems (P<0.05). No significant difference was found in the A value between A2DS2 score and ISAN score (P>0.05).Conclusion ISAN, A2DS2 and AIS-APS scoring systems all present good discrimination and calibration in predicting the risk of ischemic SAP. The AIS-APS score calculation is relatively complex, so it is suggested that ISAN and A2DS2 scoring systems be used in emergency.

Key words: acute ischemic stroke, stroke-associated pneumonia, ISAN score, A2DS2 score, AIS-APS score, PANTHERIS score

中图分类号:

R743.3

王娜,刘芦姗,王丰容. 四种评分系统对缺血性脑卒中相关性肺炎的预测价值比较[J]. 《中国康复理论与实践》, 2018, 24(6): 696-701.

WANG Na, LIU Lu-shan, WANG Feng-rong. Comparison of Four Scoring Systems in Predicting Risk of Stroke-associated Pneumonia in Patients with Acute Ischemic Stroke[J]. 《Chinese Journal of Rehabilitation Theory and Practice》, 2018, 24(6): 696-701.

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四种评分系统对缺血性脑卒中相关性肺炎的预测价值比较

Comparison of Four Scoring Systems in Predicting Risk of Stroke-associated Pneumonia in Patients with Acute Ischemic Stroke

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