Chen Zewen, Fu Rong, Zhao Jing, Huang Minglu, Gao Lina, Liu Juan
Department of Neurology,Guiyang Second People's Hospital,Guiyang,550081,China.
Lin Chuang Er Bi Yan Hou Tou Jing Wai Ke Za Zhi. 2024 Oct;38(10):947-950. doi: 10.13201/j.issn.2096-7993.2024.10.012.
To explore the predictive value of HINTS bedside examination and e-NIHSS scale for posterior circulation ischemia with vestibular symptoms. 136 cases in total patients with acute vestibular syndrome(AVS) hospitalized in our hospital from April 2021 to April 2023 were selected as the study subjects, According to the classification of AVS etiology, patients with central AVS, namely posterior circulation ischemia(PCI), were divided into case group(68 cases) and peripheral AVS patients were control group(68 cases), Collect data and perform head impulse test-nystagmus-test of skew deviation test beside the bed, two doctors evaluated the NIHSS and e-NIHSS scales for PCI patients with vestibular symptoms respecb tively, and recorded the results after they were consistent, and improved the head MRI examination. The positive rate of head pulse test in PCI patients with vestibular symptoms was 3 cases(4.41%), and 60 cases(88.24%) with peripheral symptoms; The positive rate of nystagmus test in PCI group was 64 cases(94.12%) and peripheral 21 cases(30.88%); The positive rate of eye deviation test in PCI group was 55 cases(80.88%) and peripheral 8 cases(11.76%). Comparing the data with the consistency of the final diagnosis, the sensitivity was 97.0%, the specificity was 95.7%, and the accuracy was 0.963. It passed the Kappa consistency test Kappa=0.926(<0.01). The patients in PCI group were scored, in which the NIHSS score of brainstem group was 1.51±0.59, and the e-NIHSS score was 4.05±1.71(<0.05); The NIHSS score of cerebellar group was 1.42±0.62, and the e-NIHSS score was 3.86±1.59(<0.05); NIHSS score of thalamus group was 1.31±0.73, e-NIHSS score was 3.56±1.27 (<0.05); NIHSS score of non-focus group was 1.11±0.43, e-NIHSS score was 3.06±1.20 (<0.01). The difference between e-NIHSS score and NIHSS score in each group was statistically significant. HINTS examination is highly consistent with the final diagnosis of the gold standard. The e-NIHSS scoring scale has a higher detection rate than the NIHSS scoring scale for patients with posterior circulation ischemia mainly characterize〓by vestibular symptoms.
探讨HINTS床边检查及e-NIHSS量表对伴前庭症状的后循环缺血的预测价值。选取2021年4月至2023年4月在我院住院的136例急性前庭综合征(AVS)患者作为研究对象,根据AVS病因分类,将中枢性AVS即后循环缺血(PCI)患者分为病例组(68例),外周性AVS患者为对照组(68例),收集资料并在床边进行摇头试验-眼震试验-偏斜试验,两名医生分别对有前庭症状的PCI患者进行NIHSS和e-NIHSS量表评估,待结果一致后记录,并完善头颅MRI检查。有前庭症状的PCI患者摇头试验阳性率为3例(4.41%),外周性为60例(88.24%);PCI组眼震试验阳性率为64例(94.12%),外周性为21例(30.88%);PCI组眼偏斜试验阳性率为55例(80.88%),外周性为8例(11.76%)。将数据与最终诊断的一致性进行比较,敏感度为97.0%,特异度为95.7%,准确度为0.963。经Kappa一致性检验Kappa=0.926(P<0.01)。对PCI组患者进行评分,其中脑干组NIHSS评分为1.51±0.59,e-NIHSS评分为4.05±1.71(P<0.05);小脑组NIHSS评分为1.42±0.62,e-NIHSS评分为3.86±1.59(P<0.05);丘脑组NIHSS评分为1.31±0.73,e-NIHSS评分为3.56±1.27(P<0.05);非病灶组NIHSS评分为1.11±0.43,e-NIHSS评分为3.06±1.20(P<0.01)。各组e-NIHSS评分与NIHSS评分差异有统计学意义。HINTS检查与金标准最终诊断高度一致。对于以前庭症状为主的后循环缺血患者,e-NIHSS评分量表比NIHSS评分量表有更高的检出率。