急性缺血性卒中相关肺炎评分临床应用价值分析

目的 验证急性缺血性卒中相关肺炎评分（Acute Ischemic Stroke-Associated Pneumonia Score，AISAPS）
对缺血性卒中相关肺炎的预测效果，为临床早期发现卒中相关性肺炎提供适合的筛查工具。
方法 从任丘康济新图医院缺血性卒中急性期干预、二级预防相关登记研究数据库中选取2014年
1月20日-2016年8月31日住院治疗的急性缺血性卒中患者，采用AIS-APS评分量表进行评分，应用ROC
曲线下面积确定AIS-APS对缺血性卒中相关肺炎预测的灵敏度与特异度，验证该量表的有效性，同时
验证ISANprestroke Independence（mRS），sex，age，NIHSS]、A2DS2（age，atrial fibrillation，dysphagia，sex，
stroke severity）、Kwon等评分量表对缺血性卒中患者发生卒中相关性肺炎的预测作用。
结果 共纳入3104例急性缺血性卒中患者，其中有100例（3.2%）发生肺炎；AIS-APS的ROC曲线下面
积为0.737（95%CI 0.721～0.753），敏感度0.800，特异度0.611，Youden指数0.411，最佳界值为5分。与
其他评分量表相比，AI S-APS量表ROC曲线下面积、灵敏度最高，但ISAN量表特异度最高（0.759）。
结论 AIS-APS量表对于卒中相关性肺炎的预测有一定价值，可指导临床早期筛查卒中相关性肺炎。

Analysis of Clinical Value of Acute Ischemic Stroke-Associated Pneumonia Score

Objective To evaluate the clinical value of acute ischemic stroke-associated pneumonia score
(AIS-APS) for predicting in-hospital stroke-associated pneumonia after AIS, and to provide a
suitable tool for early screening of stroke-associated pneumonia.
Methods Data of AIS patients from stroke registry database of Renqiu Kangjixintu Hospital from
January 20, 2014 to August 31, 2016 were retrospectively analyzed. All patients were evaluated
using AIS-APS, the area under the ROC curve (AUC) was used to determine the sensitivity and
specificity of this score. The predictive value of the ISAN score, A2DS2 score, Kwon score for
stroke-associated pneumonia were also evaluated.
Results A total of 3104 patients were included, and stroke-associated pneumonia occurred in 100
(3.2%) patients. The AUC of AIS-APS for predicting pneumonia was 0.737 (95%CI 0.721-0.753),
the sensitivity was 0.800, the specificity was 0.611, and the Youden index was 0.411. The best cutoff
value was 5 points. Comparing the ISAN, A2DS2, and Kwon score, the AIS-APS had the highest
sensitivity and AUC, and the ISAN score had the highest specificity (0.759).
Conclusions The AIS-APS is valuable for predicting stroke-associated pneumonia, which can be
used for early screening of stroke-associated pneumonia.