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目的探讨两种评分系统在原发性脑桥出血(primary pontine hemorrhage,PPH)患者预后评估中的效果对比。方法抽取2013年1月—2017年1月原发性脑桥出血住院患者49例,采用PPH评分、格拉斯哥昏迷(Glasgow Coma Scale,GCS)评分统计患者一般临床资料情况,以改良Rankin分级(modified Rankin Scale,m RS)预后评定死亡组和存活组,对比两组临床资料,采用受试者工作特征曲线(receiver operating characteristic,ROC)评价PPH评分预测患者死亡发生的准确性。计量资料比较采用t检验,计数资料比较采用χ2检验,P<0.05为差异有统计学意义。结果死亡组GCS评分(5.0±2.4)分低于存活组(12.7±3.3)分,死亡组血糖(9.8±3.4)mmol/L高于存活组(7.6±1.6)mmol/L,比较差异有统计学意义(均P<0.05);在是否存在瞳孔对光反射及PPH评分等方面比较,差异有统计学意义(均P<0.05)。PPH评分预测原发性脑桥出血患者死亡发生的曲线下面积为0.917,敏感度为79.3%,特异性为90%。结论 PPH评分预测原发性脑桥出血的准确性、敏感性及特异性高。
Objective To compare the effects of two scoring systems in the prognosis evaluation of patients with primary pontine hemorrhage (PPH). Methods Forty-nine inpatients with primary pontine hemorrhage from January 2013 to January 2017 were enrolled in this study. The general clinical data of patients with PPH and Glasgow Coma Scale (GCS) were scored. The modified Rankin Scale , m RS) were used to assess the prognosis of death and survival groups. The clinical data of two groups were compared. The receiver operating characteristic (ROC) was used to evaluate the PPH score to predict the accuracy of death. Measurement data were compared using t test, count data were compared using χ2 test, P <0.05 for the difference was statistically significant. Results The GCS score of death group (5.0 ± 2.4) was lower than that of surviving group (12.7 ± 3.3), and the death group was higher (9.8 ± 3.4) mmol / L than that of survival group (7.6 ± 1.6) mmol / L (P <0.05). There was significant difference in pupil reflex and PPH scores (all P <0.05). PPH predicts that the area under the curve of death in patients with primary pontine hemorrhage is 0.917, with a sensitivity of 79.3% and a specificity of 90%. Conclusion PPH score predicts the accuracy, sensitivity and specificity of primary pontine hemorrhage.