浙江医学Issue(5)：374-377,4.
动脉瘤性蛛网膜下腔出血后症状性脑血管痉挛预测指数的临床研究
Development of symptomatic vasospasm predictive index after aneurysmal subarachnoid hemorrhage
摘要
Abstract
Objective To develop a predictive index for symptomatic vasospasm after subarachnoid hemorrhage (SAH). Methods Seventy- one patients diagnosed as aneurysmal SAH (aSAH) by computed tomography underwent transcranial Doppler (TCD) examinations. The middle cerebral artery velocity (MCAV), internal carotid artery velocity (ICAV), Lindegaard ratios and va-sospasm index (VI) were obtained. The clinical data including age, sex, Hunt and Hess grade, Fisher grade, treatment (coil em-bolization, surgical clip occlusion, or conservative treatment), smoking history and hypertension history were documented. Sensi-tivity, specificity, predictive values, and overal accuracy rate of the different tests were calculated. Logistic regression was used to evaluate the predictive factors, and the coefficients of the logistic regression were integrated to develop the vasospasm pre-dictive index (VPI). Results Twenty one out of 71 patients (29.6%) developed symptomatic vasospasm after aSAH. Taking MCAV>120 cm/sec as cut- off value, the overal accuracy rate of MCAV was 80.3%for the diagnosis of clinical vasospasm;Lin-degaard ratio>3.0 as cut- off, the overal accuracy was 81.7%and VI>3.5 as cut- off the overal accuracy was 84.5%. A VPI was developed with the combination of Fisher grade, MCAV and VI;and the overal accuracy rate of the established VPI was 94.4%for clinical vasospasm detection. Conclusion The vasospasm predictive index developed in this study is superior to individual tests, which can be used to predict cerebral vasospasm after aneurysmal SAH clinical y.关键词
蛛网膜下腔出血/动脉瘤/脑血管痉挛/经颅多普勒超声Key words
Subarachnoid hemorrhage/Aneurysmal/Vasospasm/TCD引用本文复制引用
俞学斌,金国良,吴承龙,孙新芳,邵劲松,袁紫刚,鲍武乔..动脉瘤性蛛网膜下腔出血后症状性脑血管痉挛预测指数的临床研究[J].浙江医学,2014,(5):374-377,4.基金项目
浙江省医药卫生科学研究基金A类项目 （）
