不同院前评估模型对预测急性缺血性脑卒中 患者前循环大动脉闭塞的价值分析

目的 探讨不同院前评估模型对预测急性缺血性脑卒中患者前循环大动脉闭塞(LAVO)的价值。方法 将2016年5月-2018年4月本院收治的190例急性缺血性脑卒中患者分为LAVO组(55例)和非LAVO组(135例),比较2组患者FAST、LAMS、PASS、3-ISS和RACE的差异,绘制ROC曲线,评价五种量表的诊断效能。结果 LAVO组的FAST、LAMS、PASS、3-ISS和RACE分数均显著高于非LAVO组(P<0.05)。ROC曲线显示,FAST量表预测急性缺血性脑卒中患者LAVO的AUC显著高于LAMS、PASS、3-ISS和RACE(P<0.05),FAST的最佳截点为≥4分。FAST在预测急性缺血性脑卒中患者LAVO时的诊断准确率、灵敏性、特异性和阳性预测值均明显高于LAMS、PASS、3-ISS和RACE。结论 FAST在预测急性缺血性脑卒中患者LAVO中有较高应用价值,其中FAST总分值≥4分可作为急性缺血性脑卒中患者LAVO的参考指标。

The value of different prehospital evaluation models in predicting the large anterior vessel occlusion of acute ischemic stroke patients

ObjectiveTo explore the value of different prehospital evaluation models in predicting the LAVO of acute ischemic stroke patients.Methods 190 patients who suffered acute ischemic stroke from May 2016 to April 2018 in our hospital were chosen and divided into LAVO group(55 cases )and non-LAVO group(135 cases). All the patients who received FAST、LAMS、PASS、3-ISS and RACE were selected and the scores of these scales were evaluated. ROC curve were plotted and the diagnostic efficiency of different prehospital stroke scales were evaluated.Results The scores of FAST、LAMS、PASS、3-ISS and RACE in LAVO group were significantly higher than those in non-LAVO group(P<0.05).The ROC curve showed that the AUC of FAST in predicting the LAVO of acute ischemic stroke patients was significantly higher than that of LAMS 、PASS 、3-ISS and RACE( P<0.05), of which the best cut-off point for FAST was≥4 point. The diagnostic accuracy, sensitivity, specificity and positive predictive value of FAST in predicting the LAVO of acute ischemic stroke patients were significantly higher than those of LAMS、PASS、3-ISS and RACE.Conclusion FAST was valuable in predicting the LAVO of acute ischemic stroke patients. The total point ≥4 could be used as reference parameter for predicting the LAVO of acute ischemic stroke patients.