Lyden Patrick, Claesson Lennart, Havstad Suzanne, Ashwood Tim, Lu Mei
Department of Neurology, Veterans Administration Medical Center, San Diego, Calif., USA.
Arch Neurol. 2004 Nov;61(11):1677-80. doi: 10.1001/archneur.61.11.1677.
The National Institutes of Health Stroke Scale (NIHSS) was created to detect treatment-related differences in clinical trials and was designed to measure right- and left-sided cerebral hemispheric function.
To validate the original design in patients with very large strokes.
A previously published factor structure was fit to the data. Then, a new analysis was conducted to explore the underlying structure of the scale in this population. Finally, NIHSS scores and infarction volumes were compared.
The Clomethiazole for Acute Stroke Study-Ischemic, conducted in academic and community hospitals.
Individuals with acute stroke seen within 12 hours of onset. Of 1191 records available, 98% had complete NIHSS scores.
Goodness-of-fit statistic (Bentler) for each factor solution.
Two factors were found underlying the NIHSS, corresponding to the left and right hemispheres (goodness of fit = 0.97), using the previously published factor analysis. The new exploratory analysis also suggested 2 factors representing left and right brain function. The median (range) NIHSS scores were 15 (5-25) for right brain strokes and 19 (6-32) for left brain strokes (P<.001). The median (range) infarction volumes were 56.2 mL (0.1-381.5 mL) for right brain strokes and 37.8 mL (0.2-255.1 mL) for left brain strokes (P<.001). The correlation coefficient between NIHSS score and lesion volume was 0.37 (P<.001).
The underlying structure of the NIHSS conforms to cerebral hemispheric lateralization, confirming previous findings in a new population of large hemispheric strokes. Left- brain strokes score 4 points higher on the NIHSS than right brain strokes of larger volume.
美国国立卫生研究院卒中量表（NIHSS）旨在检测临床试验中与治疗相关的差异，用于测量左右大脑半球功能。
在大面积卒中患者中验证其原始设计。
将先前发表的因子结构应用于数据。然后进行新的分析以探索该量表在这一人群中的潜在结构。最后，比较NIHSS评分与梗死体积。
在学术和社区医院开展的氯美噻唑治疗急性缺血性卒中研究。
发病12小时内就诊的急性卒中患者。在1191份可用记录中，98%有完整的NIHSS评分。
每个因子解决方案的拟合优度统计量（本特勒）。
使用先前发表的因子分析，发现NIHSS有两个因子，分别对应左右半球（拟合优度 = 0.97）。新的探索性分析也提示存在代表左右脑功能的两个因子。右脑卒中和左脑卒中的NIHSS评分中位数（范围）分别为15（5 - 25）和19（6 - 32）（P<0.001）。右脑卒中和左脑卒中的梗死体积中位数（范围）分别为56.2 mL（0.1 - 381.5 mL）和37.8 mL（0.2 - 255.1 mL）（P<0.001）。NIHSS评分与病变体积的相关系数为0.37（P<0.001）。
NIHSS的潜在结构符合大脑半球的功能侧化，在新的大面积半球卒中人群中证实了先前的发现。左脑卒中在NIHSS上的得分比体积更大的右脑卒中高4分。
