Background and purpose The ideal stroke classification system needs to have validity,high reliability and applicability among different stroke research settings.The Chinese Ischemic Stroke Subclassification(CISS)and t...Background and purpose The ideal stroke classification system needs to have validity,high reliability and applicability among different stroke research settings.The Chinese Ischemic Stroke Subclassification(CISS)and the Subtypes of Ischemic Stroke Classification System(SPARKLE)have emerged recently but have not been tested using agreement analysis.As a result,the objective of this study is to investigate the level of agreement among stroke subtype classifications using CISS,SPARKLE and Trial of Org 10172 in Acute Stroke Treatment(TOAST).We also analyse the inter-rater reliability of CISS.Methods The data include 623 inpatients who have had an ischaemic stroke,accrued from Beijing Tiantan Hospital between 1 October 2015 and 19 April 2016.According to the diagnostic standards of the three subtype classification systems,299 inpatients who satisfied the requirements of our study were independently classified with etiological subtypes,and we compared the three subclassifications.Results There was substantial overall agreement among the three classification systems:CISS versus SPARKLE(kappa value=0.684,p<0.001),CISS versus TOAST(kappa value=0.615,p<0.001)and SPARKLE versus TOAST(kappa value=0.675,p<0.001).The inter-rater reliability of CISS was excellent(kappa value=0.857,p<0.001).Furthermore,among the three subtype classification systems,the variance analysis results of the etiological subtypes were not uniform.Conclusion There were generally substantial agreements among three ischaemic stroke etiological classification systems.CISS is a valid and reliable classification system,with which different stroke research centres can apply and compare data.展开更多
目的探讨血尿酸与不同分型急性缺血性脑卒中及患者早期预后的相关性。方法将225例急性缺血性脑卒中患者纳入病例组,212例同期在我院体检中心的健康体检患者纳入对照组,病例组按照TOAST(trial of org10172 in acute stroke treatment)分...目的探讨血尿酸与不同分型急性缺血性脑卒中及患者早期预后的相关性。方法将225例急性缺血性脑卒中患者纳入病例组,212例同期在我院体检中心的健康体检患者纳入对照组,病例组按照TOAST(trial of org10172 in acute stroke treatment)分型标准进行分型,均检测血尿酸水平,分析不同血尿酸水平与急性缺血性脑卒中TOAST分型的关系。根据血尿酸水平将缺血性脑卒中患者分为高尿酸组和正常尿酸组,采用NIHSS评分和Barthel Index(BI)评分于患者入院、出院时对其神经功能缺损程度和日常生活能力(ADL)进行评定,比较两组间NIHSS评分和BI评分的差异。结果病例组血清尿酸高于对照组(P<0.01),大动脉粥样硬化型、小动脉闭塞型血尿酸水平高于心源性脑栓塞型、其他明确病因型、不明原因型,差异具有统计学意义(P<0.01)。与正常尿酸组对比,高血尿酸组患者入院时、出院时的NIHSS评分和BI评分差异均有统计学意义(P<0.05)。结论血尿酸水平对急性缺血性脑卒中的TOAST分型具有一定的提示作用,而且与患者早期预后有关,尿酸水平越高,预后越差。展开更多
BACKGROUND：5-1ipoxygenase protein （ALOX5AP） has been recognized as a susceptibility gene for stroke and coronary artery diseases. The present study was to explore the role of this gene in the eastern Chinese patien...BACKGROUND：5-1ipoxygenase protein （ALOX5AP） has been recognized as a susceptibility gene for stroke and coronary artery diseases. The present study was to explore the role of this gene in the eastern Chinese patients with ischemic stroke.METHODS： Using a case-control design, we studied 658 patients with ischemic stroke and 704 unrelated population-based controls who were age- and sex-matched. The 658 patients were classified by the Trial of Org 10172 in Acute Stroke Treatment （TOAST）. Two single-nucleotide polymorphisms （SNPs） covering ALOX5AP were genotyped. RESULTS： The genotype frequencies of TG of the SNPs rs17222919 located in the promoter of the ALOX5AP gene were significantly higher in patients with ischemic stroke than in controls （OR＊=1.34, 95%C1＊=1.02-1.75）, especially in patients with ischemic stroke caused by small-artery occlusion （SAO） （OR＊=1.40, 95%C1＊=1.02-1.93）. Meanwhile, the genotype frequencies of TG and TG/ GG were higher in female patients than in the controls. After specification, the genotype frequencies of TG and TG/GG were higher in the patients than in controls with hypertension. The genotype frequencies of AG and AG/GG of the SNPs rs9579646 located in the intron of the ALOX5AP gene were higher in the controls than in the patients. After specification, the genotype frequencies of TG were higher in the controls than patients without hypertension. CONCLUSIONS： The present study suggests that sequence variants in the ALOX5AP gene are significantly associated with ischemic stroke.展开更多
文摘Background and purpose The ideal stroke classification system needs to have validity,high reliability and applicability among different stroke research settings.The Chinese Ischemic Stroke Subclassification(CISS)and the Subtypes of Ischemic Stroke Classification System(SPARKLE)have emerged recently but have not been tested using agreement analysis.As a result,the objective of this study is to investigate the level of agreement among stroke subtype classifications using CISS,SPARKLE and Trial of Org 10172 in Acute Stroke Treatment(TOAST).We also analyse the inter-rater reliability of CISS.Methods The data include 623 inpatients who have had an ischaemic stroke,accrued from Beijing Tiantan Hospital between 1 October 2015 and 19 April 2016.According to the diagnostic standards of the three subtype classification systems,299 inpatients who satisfied the requirements of our study were independently classified with etiological subtypes,and we compared the three subclassifications.Results There was substantial overall agreement among the three classification systems:CISS versus SPARKLE(kappa value=0.684,p<0.001),CISS versus TOAST(kappa value=0.615,p<0.001)and SPARKLE versus TOAST(kappa value=0.675,p<0.001).The inter-rater reliability of CISS was excellent(kappa value=0.857,p<0.001).Furthermore,among the three subtype classification systems,the variance analysis results of the etiological subtypes were not uniform.Conclusion There were generally substantial agreements among three ischaemic stroke etiological classification systems.CISS is a valid and reliable classification system,with which different stroke research centres can apply and compare data.
文摘目的探讨血尿酸与不同分型急性缺血性脑卒中及患者早期预后的相关性。方法将225例急性缺血性脑卒中患者纳入病例组,212例同期在我院体检中心的健康体检患者纳入对照组,病例组按照TOAST(trial of org10172 in acute stroke treatment)分型标准进行分型,均检测血尿酸水平,分析不同血尿酸水平与急性缺血性脑卒中TOAST分型的关系。根据血尿酸水平将缺血性脑卒中患者分为高尿酸组和正常尿酸组,采用NIHSS评分和Barthel Index(BI)评分于患者入院、出院时对其神经功能缺损程度和日常生活能力(ADL)进行评定,比较两组间NIHSS评分和BI评分的差异。结果病例组血清尿酸高于对照组(P<0.01),大动脉粥样硬化型、小动脉闭塞型血尿酸水平高于心源性脑栓塞型、其他明确病因型、不明原因型,差异具有统计学意义(P<0.01)。与正常尿酸组对比,高血尿酸组患者入院时、出院时的NIHSS评分和BI评分差异均有统计学意义(P<0.05)。结论血尿酸水平对急性缺血性脑卒中的TOAST分型具有一定的提示作用,而且与患者早期预后有关,尿酸水平越高,预后越差。
基金supported by Research Foundation of Jiangsu Province Hygiene Committee(H201005)
文摘BACKGROUND：5-1ipoxygenase protein （ALOX5AP） has been recognized as a susceptibility gene for stroke and coronary artery diseases. The present study was to explore the role of this gene in the eastern Chinese patients with ischemic stroke.METHODS： Using a case-control design, we studied 658 patients with ischemic stroke and 704 unrelated population-based controls who were age- and sex-matched. The 658 patients were classified by the Trial of Org 10172 in Acute Stroke Treatment （TOAST）. Two single-nucleotide polymorphisms （SNPs） covering ALOX5AP were genotyped. RESULTS： The genotype frequencies of TG of the SNPs rs17222919 located in the promoter of the ALOX5AP gene were significantly higher in patients with ischemic stroke than in controls （OR＊=1.34, 95%C1＊=1.02-1.75）, especially in patients with ischemic stroke caused by small-artery occlusion （SAO） （OR＊=1.40, 95%C1＊=1.02-1.93）. Meanwhile, the genotype frequencies of TG and TG/ GG were higher in female patients than in the controls. After specification, the genotype frequencies of TG and TG/GG were higher in the patients than in controls with hypertension. The genotype frequencies of AG and AG/GG of the SNPs rs9579646 located in the intron of the ALOX5AP gene were higher in the controls than in the patients. After specification, the genotype frequencies of TG were higher in the controls than patients without hypertension. CONCLUSIONS： The present study suggests that sequence variants in the ALOX5AP gene are significantly associated with ischemic stroke.
