目的探索美国国立卫生研究院卒中量表(national institute of health stroke scale,NIHSS)评分与高血压性脑出血老年患者病死率、致残率和疾病相关耻辱感的相关性,为该病的临床干预提供依据。方法回顾性分析2019年1月—2020年12月于南...目的探索美国国立卫生研究院卒中量表(national institute of health stroke scale,NIHSS)评分与高血压性脑出血老年患者病死率、致残率和疾病相关耻辱感的相关性,为该病的临床干预提供依据。方法回顾性分析2019年1月—2020年12月于南通市第一人民医院治疗的高血压性脑出血老年患者133例的临床资料。采用Superman检验评估NIHSS评分与病死率、致残率、疾病耻辱感之间的相关性,采用受试者工作特征曲线(receiver operator characteristic curve,ROC),评估NIHSS评分对病死率、致残率和疾病耻辱感的预测诊断效能。结果相关性分析表明,老年高血压性脑出血患者的NIHSS评分与患者的病死率(r=0.677,P<0.001)、致残率(r=0.486,P<0.001)和耻辱感正相关(r=0.395,P<0.001)。NIHSS评分对患者病死率的预测ROC曲线下面积为0.897 (P<0.001),最佳截断值为14分,敏感度为85.19%,特异度为86.08%。NIHSS评分对患者致残率的预测ROC曲线下面积0.782 (P<0.001),最佳截断值为10分,敏感度为73.53%,特异度为71.11%。NIHSS评分对患者疾病耻辱感的预测ROC曲线下面积0.783(P<0.001),最佳截断值为11分,敏感度为75.00%,特异度为71.43%。结论 NIHSS评分与高血压性脑出血老年患者病死率、致残率和疾病相关耻辱感正相关,可望用于患者的病死率、致残率和疾病相关耻辱感的预测诊断,效能良好。展开更多
OBJECTIVE： To evaluate the effectiveness and safety of the Xingnao Kaiqiao needling method for treating acute ischemic stroke.DATA SOURCES： We retrieved relevant randomized controlled trials involving Xingnao Kaiqia...OBJECTIVE： To evaluate the effectiveness and safety of the Xingnao Kaiqiao needling method for treating acute ischemic stroke.DATA SOURCES： We retrieved relevant randomized controlled trials involving Xingnao Kaiqiao acupuncture for treatment of acute ischemic stroke. The China National Knowledge Infrastructure, Weipu Information Resources System, Wanfang Medical Data System, Chinese Biomedical Literature Database, Cochrane Library, and Pub Med were searched from June 2006 to March 2016.DATA SELECTION： We analyzed randomized and semi-randomized clinical controlled trials that compared Xingnao Kaiqiao acupuncture with various control treatments, such as conventional drugs or other acupuncture therapies, for treatment of acute ischemic stroke. The quality of articles was evaluated according to the Cochrane Handbook for Systematic Reviews of Interventions（Version 5.1）, and the study was carried out using Cochrane system assessment methods. Rev Man 5.2 was used for the meta-analysis of the included studies.OUTCOME MEASURES： The mortality rate, disability rate, activities of daily living（Barthel Index）, and clinical efficacy were observed.RESULTS： Twelve studies met the inclusion criteria for this review. The meta-analysis showed that between Xingnao Kaiqiao acupuncture and the control treatment, Xingnao Kaiqiao acupuncture reduced the disability rate [risk ratio（RR） = 0.51, 95% confidence interval（CI） = 0.27-0.98, z = 2.03, P 〈 0.05], elevated the activities of daily living（weighted mean difference = 12.23, 95% CI： 3.66-20.08, z = 2.80, P 〈 0.005）, and had greater clinical efficacy（RR = 1.61, 95% CI： 1.23-2.09, z = 3.53, P 〈 0.0004）. However, there was no significant difference in mortality rate（RR = 0.61, 95% CI： 0.15-2.45, z = 0.70, P 〉 0.05）. CONCLUSION： The Xingnao Kaiqiao needling method is effective and safe for acute ischemic stroke. However, there was selective bias in this study, and the likelihood of measurement bias is high. Thus, more high-quality rand展开更多
文摘目的探索美国国立卫生研究院卒中量表(national institute of health stroke scale,NIHSS)评分与高血压性脑出血老年患者病死率、致残率和疾病相关耻辱感的相关性,为该病的临床干预提供依据。方法回顾性分析2019年1月—2020年12月于南通市第一人民医院治疗的高血压性脑出血老年患者133例的临床资料。采用Superman检验评估NIHSS评分与病死率、致残率、疾病耻辱感之间的相关性,采用受试者工作特征曲线(receiver operator characteristic curve,ROC),评估NIHSS评分对病死率、致残率和疾病耻辱感的预测诊断效能。结果相关性分析表明,老年高血压性脑出血患者的NIHSS评分与患者的病死率(r=0.677,P<0.001)、致残率(r=0.486,P<0.001)和耻辱感正相关(r=0.395,P<0.001)。NIHSS评分对患者病死率的预测ROC曲线下面积为0.897 (P<0.001),最佳截断值为14分,敏感度为85.19%,特异度为86.08%。NIHSS评分对患者致残率的预测ROC曲线下面积0.782 (P<0.001),最佳截断值为10分,敏感度为73.53%,特异度为71.11%。NIHSS评分对患者疾病耻辱感的预测ROC曲线下面积0.783(P<0.001),最佳截断值为11分,敏感度为75.00%,特异度为71.43%。结论 NIHSS评分与高血压性脑出血老年患者病死率、致残率和疾病相关耻辱感正相关,可望用于患者的病死率、致残率和疾病相关耻辱感的预测诊断,效能良好。
基金supported by the Support Program(Ⅱ)of Hundreds of Universities Outstanding Innovative Talents in Hebei Province of China,No.BR2-104
文摘OBJECTIVE： To evaluate the effectiveness and safety of the Xingnao Kaiqiao needling method for treating acute ischemic stroke.DATA SOURCES： We retrieved relevant randomized controlled trials involving Xingnao Kaiqiao acupuncture for treatment of acute ischemic stroke. The China National Knowledge Infrastructure, Weipu Information Resources System, Wanfang Medical Data System, Chinese Biomedical Literature Database, Cochrane Library, and Pub Med were searched from June 2006 to March 2016.DATA SELECTION： We analyzed randomized and semi-randomized clinical controlled trials that compared Xingnao Kaiqiao acupuncture with various control treatments, such as conventional drugs or other acupuncture therapies, for treatment of acute ischemic stroke. The quality of articles was evaluated according to the Cochrane Handbook for Systematic Reviews of Interventions（Version 5.1）, and the study was carried out using Cochrane system assessment methods. Rev Man 5.2 was used for the meta-analysis of the included studies.OUTCOME MEASURES： The mortality rate, disability rate, activities of daily living（Barthel Index）, and clinical efficacy were observed.RESULTS： Twelve studies met the inclusion criteria for this review. The meta-analysis showed that between Xingnao Kaiqiao acupuncture and the control treatment, Xingnao Kaiqiao acupuncture reduced the disability rate [risk ratio（RR） = 0.51, 95% confidence interval（CI） = 0.27-0.98, z = 2.03, P 〈 0.05], elevated the activities of daily living（weighted mean difference = 12.23, 95% CI： 3.66-20.08, z = 2.80, P 〈 0.005）, and had greater clinical efficacy（RR = 1.61, 95% CI： 1.23-2.09, z = 3.53, P 〈 0.0004）. However, there was no significant difference in mortality rate（RR = 0.61, 95% CI： 0.15-2.45, z = 0.70, P 〉 0.05）. CONCLUSION： The Xingnao Kaiqiao needling method is effective and safe for acute ischemic stroke. However, there was selective bias in this study, and the likelihood of measurement bias is high. Thus, more high-quality rand
