脑实质内出血中1/2ABC公式与2/3Sh公式的比较。
Comparison between the formula 1/2ABC and 2/3Sh in intracerebral parenchyma hemorrhage.
作者信息
Yan Jing, Zhao Kaijun, Sun Jialan, Yang Wanlin, Qiu Yulan, Kleinig Timothy, Fu Yi, Chen Shengdi
机构信息
Department of Neurology and Institute of Neurology, Ruijin Hospital, Shanghai Jiaotong University School of Medicine, Shanghai, China.
出版信息
Neurol Res. 2013 May;35(4):382-8. doi: 10.1179/1743132812Y.0000000141.
BACKGROUND AND PURPOSE
The 1/2ABC formula is the method most commonly used in clinical practice to rapidly estimate intracerebral hemorrhage (ICH) volume. We aimed to compare this method with the alternative '2/3Sh' formula for both regularly and irregularly-shaped hematomas.
METHODS
Computed tomography (CT) images from 344 ICH patients (median volume: 16·66 ml) were retrospectively reviewed. According to the maximum slice, the shape was classified into regular or irregular (multilobular, conical, and other). Volumes as determined by the 1/2ABC and 2/3Sh formulas were compared against the gold standard, computer-assisted planimetry, for various hematoma shapes.
RESULTS
With the 1/2ABC method, errors were seen non-significantly more frequently for irregularly-shaped hematomas [OR: 2.85 (95% CI: 0.65-12.50)]. The 1/2ABC method misclassified a greater proportion of hematomas as greater or less than 30 ml in volume: 7.0% (95% CI: 6.0-9.9%). Both the 1/2ABC and 2/3Sh formulas correlated well with gold standard (correlation coefficients >0.9 for each shape). While there was no statistically significant measurement error bias for either method, the 95% confidence intervals of the limit of agreement for 2/3Sh were tighter: -0.22 ml (-4.7-4.25 ml) versus 2·50 ml (-10.35-15.34 ml). Measurement errors were significantly greater with the 1/2ABC method, for both regular and irregular hematomas [1.17 ml (0.48-2.83 ml) versus 0.88 ml (0.42-1.68 ml) and 2.65 ml (1.07-5.88 ml) versus 0·99 ml (0.47-2.28 ml); P<0.05, respectively], although the magnitude of error would only rarely be clinically relevant for regular hematomas. Errors were most evident in assessing multilobular-shaped hematomas [6.49 ml (3.35-13.98 ml) versus 1.86 ml (0.96-9.94 ml); P<0·001].
CONCLUSIONS
The 2/3Sh formula leads to fewer clinically-relevant hematoma volume misclassifications than the 1/2ABC formula, and is particularly superior in estimating volumes of irregularly-shaped hematomas.
背景与目的
1/2ABC公式是临床实践中最常用于快速估算脑出血（ICH）体积的方法。我们旨在比较该方法与用于规则和不规则形状血肿的替代“2/3Sh”公式。
方法
回顾性分析344例ICH患者（中位体积：16.66 ml）的计算机断层扫描（CT）图像。根据最大层面，将形状分为规则或不规则（多叶形、锥形及其他）。将1/2ABC和2/3Sh公式确定的体积与各种血肿形状的金标准——计算机辅助平面测量法进行比较。
结果
采用1/2ABC方法时，不规则形状血肿出现误差的频率略高但无显著差异[比值比：2.85（95%置信区间：0.65 - 12.50）]。1/2ABC方法将更多比例的血肿误分类为体积大于或小于30 ml：7.0%（95%置信区间：6.0 - 9.9%）。1/2ABC和2/3Sh公式与金标准的相关性均良好（每种形状的相关系数均>0.9）。虽然两种方法均无统计学显著的测量误差偏差，但2/3Sh的一致性界限的95%置信区间更窄：-0.22 ml（-4.7 - 4.25 ml），而1/2ABC为2.50 ml（-10.35 - 15.34 ml）。1/2ABC方法的测量误差在规则和不规则血肿中均显著更大[1.17 ml（0.48 - 2.83 ml）对0.88 ml（0.42 - 1.68 ml）以及2.65 ml（1.07 - 5.88 ml）对0.99 ml（0.47 - 2.28 ml）；P均<0.05]，尽管对于规则血肿，误差大小在临床上很少具有相关性。在评估多叶形血肿时误差最为明显[6.49 ml（3.35 - 13.98 ml）对1.86 ml（0.96 - 9.94 ml）；P<0.001]。
结论
与1/2ABC公式相比，2/3Sh公式导致的临床相关血肿体积误分类更少，在估算不规则形状血肿体积方面尤其优越。
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