实用临床医药杂志2012，Vol.16Issue(15)：27-31,5.
NIHSS预测幕上自发性脑出血早期血肿扩大的临床研究
Application of NIHSS in the prediction of early hematoma expansion in patients with supratentorial intracerebral hemorrhage
唐煜明 1高阳2
作者信息
- 1. 江苏省滨海县中医院,江苏滨海,224500
- 2. 江苏省盐城市一院神经内科,江苏盐城,224001
- 折叠
摘要
Abstract
Objective To determine whether the National Institutes of Health Stroke Scale ( NIHSS) score is associated with early hematoma expansion ( HE) in patients with supratentorial intracerebral hemorrhage (SIL). Methods The clinical data of SIL 86 patients were retrospectively reviewed in the study. All patients underwent cranial CT scan within 6 hours of symptom onset and a repeat computed tomography within 24 -48 hours. Significant HE was defined as hematoma enlargement ≥33% or≥12. 5 mL according to CT images. Clinical features were compared between patients with or without HE. Multivariable logistic regression was applied to confirm the independent indicators of HE. The predictive value of NIHSS score in HE was evaluated with receiver - operating characteristic ( ROC) curve. Results HE occurred in 14 patients( 16.3% ) . On simple analysis,the predictors of HE were large baseline hematoma volume,high NIHSS score and high systolic/diastolic BP level on admission. Multiple logistic regression analysis showed that HE was associated with worsening of NIHSS score ( OR 1.355 [95% CI 1.050-1.748],P =0.020) and high SBP level (OR 1.061 [95% CI 1. 004 - 1. 122 ] ,P =0. 036). On ROC analysis,the score demonstrated good performance to indicate HE with an area under the curve of 0. 817(95% CI 0. 701 -0.934). With NIHSS ≥6,the sensitivity and specificity could reach 85. 7% and 66. 7% to predict HE. Given a score ≥11,the sensitivity (57.1% ) suffered at high specificity (94. 4% ). Conclusion NIHSS assessment may be a useful approach to predict early HE. Those with scores of 6 or more will have high risk of HE.关键词
脑出血/血肿扩大/美国国立卫生研究院卒中量表Key words
intracerebral hemorrhage/hematoma expansion/National Institutes of Health Stroke Scale分类
医药卫生引用本文复制引用
唐煜明,高阳..NIHSS预测幕上自发性脑出血早期血肿扩大的临床研究[J].实用临床医药杂志,2012,16(15):27-31,5.
