三种量表预测自发性脑出血患者预后的研究

目的对比3种脑出血量表在预测自发性脑出血（intracerebral hemorrhage，ICH）患者预后中的作用。方法选择自发性脑出血患者61例。入院时采用Hemphill等的原始的ICH量表（original ICH score，OICH）及Chenug等的改良的ICH量表（modified ICH score，MICH）、新的ICH量表（new ICH score，NICH）进行评分。同时于入院时采用美国国立卫生研究院卒中量表（NIHSS）、Barthel指数评分。3个月时进行NIHSS、Barthel指数和改良的Rankin量表（MRS）评分。分析3种ICH量表与其他量表评分的相关性；以MRS为标准，对比3种ICH量表评价脑出血患者预后的准确性。结果①3种ICH量表评分与脑出血患者入院时NIHSS评分和3个月MRS、NIHSS评分均呈正相关，差异均有统计学意义（P〈0．01），而与入院时和3个月Barthel指数呈负相关，差异均有统计学意义（P〈0．01）。②与MRS量表比较，OICH、MICH、NICH量表判断ICH患者预后不良的敏感性分别为73．1％、84．6％、80．8％，特异性分别为80．0％、88．6％、60．0％，符合率分别为77．0％、86．9％、68．9％。结论OICH、MICH、NICH量表评分与脑出血患者神经功能缺损程度相关。3种量表相比，MICH量表对脑出血预后判断的敏感性、特异性及符合率最高。

Predicting the prognosis in patients with spontaneous intracerebral hemorrhage with 3 kinds of intracerebral hemorrhage scores: a comparison study

Objective To compare the effects of 3 kinds of intracerebral hemorrhage scores (ICH scores) on predicting the prognosis in patients with mild to moderate spontaneous ICH. Methods Sixty-one patients with mild to moderate ICH were selected. Original ICH score (OICH), modified ICH score (MICH) and new ICH score (NICH) were performed at admission. At the same time, the patients were assessed with the National Institutes of Health Stroke Scale (NIHSS) and the Barthel Index (BI) scores at admission, and they were also assessed with BI and the modified Rankin scale (mRS) scores at 3 months after hemorrhage. The correlations between the 3 ICH scores and other scales' scores were analyzed; using the mRS as a standard, the prognostic accuracy in patients with ICH was evaluated by comparing the 3 ICH scores. Results All the 3 ICH scores were positively correlated (P<0.01) with those of NIHSS at admission and those of mRS and NIHSS after 3 months, and they were negatively correlated (P<0.01) with those of BI at admission and 3 months after hemorrhage(P<0.01). The OICH, MICH and NICH scores in predicting the sensitivity of poor prognosis were 73.1%, 84.6%, and 80.8% respectively, and the specificity were 80.00%, 88.57% and 60.00%, respectively. Conclusions The OICH, MICH and NICH scores were associated with the degree of neurological functional defects in patients with ICH. The MICH scores have the highest sensitivity, specificity and accuracy in predicting the prognosis of ICH among the 3 ICH scores.