Dragon评分对急性缺血性脑卒中静脉溶栓预后的预测价值

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Abstract Objective To evaluate the prognostic value of Dragon score in patients with acute ischemic stroke (AIS)treated with intravenous urokinase thrombolytic therapy. Methods A total of 82 AIS patients hospitalized in Department of Neurology, People′s Hospital of Yingde City, Guangdong Province from January 1, 2019 to October 31, 2020 who received intravenous thrombolysis of urokinase 1 000 000 units were selected as the research objects. Dragon score was performed on each enrolled patient. The modified Rankin score (mRS) was followed up one month after thrombolytic therapy. The mRS score was used as the prognostic index, mRS ＜3 points was defined as good prognosis, mRS＞4 was defined as bad outcome, and the relationship between Dragon score and prognosis of thrombolytic therapy was evaluated. Results After 1 month, 57 patients (69.51%) had good outcome (mRS ＜3 points) and 13 patients (15.85%) had bad outcome (mRS ＞4 points). Pearson correlation coefficient analysis showed that there was a positive correlation between mRS score and Dragon score after 1 month of thrombolysis (P＜0.05). The area under the receiver operating characteristic (ROC) curve (AUC) for predicting good outcome after 1 month was 0.866 (95%CI: 0.778-0.954), when Dragon score＜3 points, its sensitivity and specificity were 76.0% and 82.5%, positive predictive value and negative predictive value were 65.5% and 88.7%, respectively. AUC was 0.980 (95%CI: 0.952-1.008) for predicting adverse prognosis after 1 month. The best prediction was achieved when Dragon score ＞4 points, the sensitivity, specificity, positive predictive value and negative predictive value were 92.3%, 94.2%, 75% and 98.5% respectively. Conclusion The Dragon score is highly accurate in predicting the prognosis of venous thrombolysis in patients with acute cerebral arterial thrombosis,with a higher score indicative of a poorer prognosis.

Key words： Acute ischemic stroke Intravenous thrombolysis Dragon score Urokinase

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