[电子NIHSS尺度与HINTS相结合的评估,用于带有前体症状的后循环缺血性中风]
Zewen Chen1, Rong Fu1, Jing Zhao1
1Department of Neurology，Guiyang Second People's Hospital，Guiyang，550081，China.
概括
在急性前庭综合征 (AVS) 患者诊断后部循环缺血 (PCI) 时,HINTS床边检查非常准确. 国家卫生研究院增强的中风量表 (e-NIHSS) 在检测前庭症状的PCI方面比标准NIHSS更有效.
科学领域:
- 神经学 神经学
- 诊断成像 诊断成像 诊断成像
- 临床医学 临床医学
背景情况:
- 急性前体综合征 (AVS) 提出了诊断挑战,通常模仿外围原因.
- 区分中心AVS (后部循环缺血症 - - PCI) 和外围AVS对于及时干预至关重要.
- HINTS (头部冲动,肌,的测试) 检查和NIHSS (国家卫生研究院中风量表) 是已知的诊断工具.
研究的目的:
- 评估HINTS床边检查和扩展的NIHSS (e-NIHSS) 尺度的预测准确性,用于识别急性前体综合征 (AVS) 患者的后部循环缺血症 (PCI).
- 将e-NIHSS尺度的检测率与PCI和前庭症状患者的标准NIHSS尺度进行比较.
主要方法:
- 一组136名AVS患者被追溯分析,分为病例组 (68名PCI患者) 和对照组 (68名外围AVS患者).
- 在床边进行HINTS检查组件 (头部冲动测试,阴沉,偏斜偏差测试).
- 两位独立的医生为患有PCI和前庭症状的患者使用NIHSS和e-NIHSS尺度,结果通过头部MRI验证.
- 卡帕一致性测试用于评估评价者之间的可靠性和与黄金标准诊断的一致性.
主要成果:
- HINTS检查显示了高的诊断性能,灵敏度为97.0%,特异性为95.7%,准确度为0.963 (卡帕=0.926,P<0.01).
- 电子NIHSS尺度显示,与NIHSS尺度相比,在不同的PCI位置 (脑干,小脑,丘脑) 和非焦点组中,统计学上显著的得分更高.
- 对于HINTS组件的特定阳性率有所不同:头部脉冲测试 (PCI:4.41%,外围:88.24%),鼻 (PCI:94.12%,外围:30.88%) 和眼睛偏差 (PCI:80.88%,外围:11.76%).
结论:
- HINTS床边检查是一种高度可靠的工具,与AVS患者后部循环缺血的黄金标准诊断表现出极好的一致性.
- 与标准NIHSS相比,e-NIHSS评分表提供了更高的检测率,用于识别以前庭症状为特征的后部循环缺血.
- 整合HINTS和e-NIHSS可以改善急性前庭症状患者中风的早期诊断和管理.
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