两种CT血管造影评分用于评测老年脑卒中患者再次诱发脑梗死风险效果比较

夏兰兰

[摘要] 目的 比较两种CT血管造影评分（Maas评分和Tan评分）对老年脑卒中患者再次诱发脑梗死风险的预测效果。 方法 选取2017年3月至2019年3月就诊于我科确诊为急性脑梗死的老年患者240例为研究对象，患者年龄67～88岁，平均（78.7±9.6）岁，随访期1年，观察组为随访期间发生再发脑梗死患者，共计79例，对照组为随访期间未再发脑梗死患者，共計161例。观察两组患者基线资料、病情差异、主要供应动脉平均血流速度、并发症比例情况以及Maas评分和Tan评分差异，ROC曲线分析两者对于老年脑卒中患者再次诱发脑梗死风险的预测价值。 结果 两组患者基线资料可比，病情相仿，观察组大脑中动脉平均血流速度明显小于对照组（P=0.031），两组患者包括肺部感染、脑出血、心肌梗死、心力衰竭及深静脉血栓在内的主要并发症比较，差异无统计学意义（P>0.05），Maas评分和Tan评分用于评测老年脑卒中患者再次诱发脑梗死风险均具有一定的预测价值，P值分别为0.061和0.000，但Tan评分优势更为明显，ROC曲线下面积0.252，P值0.007。 结论 Maas评分和Tan评分对于老年脑卒中患者再次诱发脑梗死风险均有一定预测价值，但Tan评分预测价值更高。

[关键词] X线计算机;侧支循环;脑梗死;血流速度

[中图分类号] R743.3          [文献标识码] B          [文章编号] 1673-9701（2021）12-0119-04

Comparison of two kinds of CT angiography scores in evaluating the risk points of re induced cerebral infarction in elderly patients with stroke

XIA Lanlan

Department of Radiology， Xuzhou Rehabilitation Hospital in Jiangsu Province， Xuzhou   221000， China

[Abstract] Objective To compare the predictive value of two kinds of CT angiography scores（Maas score and Tan score） in predicting the risk of re induced cerebral infarction in elderly patients with stroke. Methods  A total of 240 elderly patients with acute cerebral infarction diagnosed in our department from March 2017 to March 2019 were selected as the research objects. The age of the patients was between 67 and 88 years old， with an average age of （78.7±9.6） years old. The observation group was 79 patients with recurrent cerebral infarction during the follow-up period， and the control group was 161 patients with no recurrence of cerebral infarction during the follow-up period. The baseline data， disease difference， mean blood flow velocity of main supply arteries， complications， Maas score and Tan score were observed between the two groups. ROC curve was used to analyze the predictive value of the two groups for the risk of re induced cerebral infarction in elderly stroke patients. Results  The mean blood flow velocity of middle cerebral artery in the observation group was significantly lower than that in the control group（P=0.031）. There was no significant difference in major complications including pulmonary infection， cerebral hemorrhage， myocardial infarction， heart failure and deep vein thrombosis between the two groups（P>0.05）. Maas score and Tan score had certain predictive value in assessing the risk of re inducing cerebral infarction in elderly patients with stroke， P=0.061 and 0.000 respectively， but the advantage of Tan score was more obvious， the area under ROC curve was 0.252， P=0.007. Conclusion  Maas score and Tan score have certain predictive value for the risk of re induced cerebral infarction in elderly patients with stroke， but the tan score has a higher predictive value.

[Key words] X-ray computed; Collateral circulation; Brain infarction; Blood flow velocity

脑卒中又称脑梗死，是由于脑部组织血液循环障碍导致脑组织缺血、缺氧所引发的缺血性坏死或软化[1-2]。该病作为最常见的脑血管病，其发病率约占脑血管病发病率70%左右，且有逐年上升趋势[3]。脑卒中以中老年患者多见，依据病因可分类为大脑动脉粥样硬化型、心源性栓塞型、小动脉闭塞型及不明原因型;依据梗死部位亦可分为全前循环梗死、部分前循环梗死、后循环梗死及腔隙性梗死[4-5]。该病……