【摘要】 目的：脑血管病大致可分为2个亚型，即脑缺血(cerebral ischemia,CI)和脑出血(cerebral hemorrhage,CH)，目前还没有可以预测脑血管病亚型的模型。本研究旨在建立一个脑血管疾病亚型的预测模型。方法：本研究共纳入1 200名脑血管病患者，其中1 081名(90%)患者的数据用于建立CI-CH量表，119名(10%)患者的数据对CI-CH量表进行测试。通过t检验和Fisher’s检验对预测因子进行第1次筛选，利用logistic回归对预测因子进行第2次筛选，以确定CI-CH量表的预测因子；参考OR值确定CI-CH量表的各因子的分值，计算约登指数作为CI-CH量表的分界点。结果：最终选择了9个危险因素作为评分系统，包括年龄(≥75岁为-1;<75岁为0),BMI(24-28 kg/m~2为-1,>28 kg/m~2为-2)，高血压等级(1级为1,2级为2,3级为3)，糖尿病(无为0，有为-1)，使用降压药物(否为0，是为-2)，饮酒量(<60 g/d为1，≥60 g/d为2)，尿酸(低于正常为0，正常为-1，高于正常为-2)，低密度脂蛋白胆固醇(<2 mmol/L为0,2-4 mmol/L为-1,>4 mmol/L为-2)，高密度脂蛋白胆固醇(<1.55 mmol/L为0，≥1.55 mmol/L为2)。得分大于0的患者被归入CH组，反之，被归入CI组；其敏感性、特异性和准确性分别为74.5%、77.9%和76.4%。结论：CI-CH量表可以帮助临床医生预测脑血管疾病的亚型。更多还原

【Abstract】 Objective: Cerebrovascular disease can be roughly divided into 2 subtypes: Cerebral ischemia(CI) and cerebral hemorrhage(CH). No scale currently exist that can predict the subtypes of cerebrovascular diseases. This study aims to establish a prediction scale for the subtypes of cerebrovascular diseases.Methods: A total of 1 200 cerebrovascular disease patients were included in this study, data from 1 081(90%) patients were used to establish the CI-CH risk scale, and data from 119(10%) patients were used to test it. Risk factors for the CI-CH risk scale were identified by 2 screens, with two-tailed student’s t-test and two-tailed Fisher’s exact test preliminarily and with logistic regression analysis further. The scores of each risk factor for CI-CH risk scale were determined according to the odds rate, and the cut-off point was determined by Youden index.Results: Nine risk factors were ultimately selected for score system, including age(≥75 years old was -1, <75 years old was 0), BMI(<24 kg/m~2 was 0, 24-28 kg/m~2 was-1,>28 kg/m~2 was -2), hypertension grade(grade 1 was 1, grade 2 was 2, and grade 3 was 3),diabetes status(no was 0, yes was-1), antihypertensive drug use(no was 0, yes was -2),alcohol consumption(<60 g/d was 1, ≥60 g/d was 2), uric acid(less than normal was 0,normal was -1, high than normal was -2), LDL cholesterol(<2 mmol/L was 0, 2-4 mmol/L was -1, and >4 mmol/L was -2), and HDL cholesterol(<1.55 mmol/L was 0, ≥1.55 mmol/L was 2). Patients with a score more than 0 were classified as the CH group, Conversely, they were assigned to the CI group; its sensitivity, specificity, and accuracy were 74.5%, 77.9%,and 76.4%, respectively.Conclusion: The CI-CH risk scale can help the clinician predict the subtypes of cerebrovascular diseases.更多还原