| Objective: Using the National Institutes of Health Stroke Scale scores,the comparative analysis of acute anterior circulation artery occlusive cerebral infarction and the artery occlusive cerebral infarction clinical manifestation,whether explicitly NIHSS score of artery occlusion have predictive value,determine the NIHSS score concluded before the best cut-off value circulation artery occlusion and independent risk factors.Methods: Retrospective analysis was performed on hospitalized patients with acute anterior circulatory ischemic stroke who were admitted to the department of neurology of Handan central hospital from July 2017 to July 2019 and were in the onset window within 6 hours.According to the responsible vessels shown by CTA on head and neck artery computed tomography angiography,the included patients with acute anterior circulation ischemic stroke were divided into the non-arterial occlusion group and the arterial occlusion group,of which 39 patients were in the non-arterial occlusion group and 104 patients in the arterial occlusion group.According to the different time Windows of onset,the non-arterial occlusion group and the arterial occlusion group were subdivided into ?3h and 3-6h groups respectively.Collect patients admitted to hospital after the general information,clinical manifestation,medical history,test results,such as head and neck artery CTA images,NIHSS score on admission,draw the receiver-operating characteristic curve,and calculate the area under the curve,calculated the sensitivity,specificity,clear whether the NIHSS score against former circulation artery occlusion has a certain meaning,determine the optimal cut-off value of NIHSS score.Univariate logistic regression analysis and multivariate logistic regression analysis were carried out for the sub-items in NIHSS score to select the independent risk factors for arterial occlusion.Results: Totally,there are 143 patients met the inclusion criteria,including 39 patients in the non-arterial occlusion group,with onset time window ?3 hours NIHSS score of 6.69±3.82 and onset time between 3 hours and 6 hours NIHSS score of5.73±4.25,and 104 patients in the arterial occlusion group,with onset time window ?3hours NIHSS score of 12.25±7.62 and onset time between 3 and 6 hours NIHSS score of 11.79±6.81.There was no significant difference between the two groups in thegeneral baseline data,and the score of the arterial occlusion group was significantly higher than that of the non-arterial occlusion group.ROC curves were drawn for the scores of the two groups.It could be seen that the AUC value of the area under the operating characteristic curve of the subjects with the onset time ?3 hours was 0.783(P<0.05),and the optimal cut-off value of the NIHSS score was 8.5,with the specificity of 63.5% and the sensitivity of 89.6%.The AUC value of the area under the working characteristic curve of subjects with the onset time of 3-6 hours was 0.734(P<0.05),and the optimal cut-off value of NIHSS score was 7.5,with a specificity of 64.3% and a sensitivity of 87.8%.After univariate logistic regression analysis and multivariate logistic regression analysis,the results showed that "level of consciousness question"(OR3.908,95% CI1.159 ~ 13.172;P=0.028),"gaze"(OR3.759,95% CI1.294 ~ 10.922;P=0,015)and "motor leg"(OR3.194,95% ci1.167-8.740).P=0.024(P<0.05)are independent risk factors for anterior arterial occlusion.Conclusion: NIHSS score has a determined predictive value for acute anterior arterial occlusive cerebral infarction.The time window is ?3 hours,the optimal cut-off value of NIHSS score is 8.5,the time window of NIHSS score is 3-6 hours,and the optimal cut-off value of NIHSS score is 7.5."level of consciousness question","gaze" and "motor leg" are independent risk factors for aortic occlusion. |
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