[1]崔梦娇,陈璐,王芳,等.急性缺血性脑卒中出血转化预测模型的系统评价[J].军事护理,2023,40(10):101-106.[doi:10.3969/j.issn.2097-1826.2023.10.024]
　CUI Mengjiao,CHEN Lu,WANG Fang,et al.Prediction Models of Hemorrhagic Transformation in Acute Ischemic Stroke: A Systematic Review[J].Nursing Journal Of Chinese People's Laberation Army,2023,40(10):101-106.[doi:10.3969/j.issn.2097-1826.2023.10.024]
点击复制

急性缺血性脑卒中出血转化预测模型的系统评价
分享到：

《军事护理》[ISSN:2097-1826/CN:31-3186/R]

卷:
40
期数:
2023年10期
页码:
101-106
栏目:
循证护理
出版日期:
2023-10-15

文章信息/Info

Title:
Prediction Models of Hemorrhagic Transformation in Acute Ischemic Stroke: A Systematic Review
文章编号:
2097-1826(2023)10-0101-06
作者:
崔梦娇1; 陈璐2; 王芳3; 何满兰3; 何茜茜3
(1.南京鼓楼医院 急诊科,江苏 南京 210000; 2.南京鼓楼医院 护理部; 3.南京鼓楼医院 神经外科)
Author(s):
CUI Mengjiao1; CHEN Lu2; WANG Fang3; HE Manlan3; HE Qianqian3
(1.Department of Emergency,Nanjing Drum Tower Hospital,Nanjing 210000,Jiangsu Province,China; 2.Department of Nursing,Nanjing Drum Tower Hospital; 3.Department of Neurosurgery,Nanjing Drum Tower Hospital)
关键词:
急性缺血性脑卒中;  出血转化;  预测;  模型;  护理
Keywords:
acute ischemic stroke;  hemorrhagic transformation;  prediction;  model;  nursing
分类号:
R47; R473.54
DOI:
10.3969/j.issn.2097-1826.2023.10.024
文献标志码:
A
摘要:
目的 系统评价急性缺血性脑卒中(acute ischemic stroke,AIS)出血转化风险预测模型,为临床决策工具的选择及护理风险评估工具的开发提供参考和借鉴。方法 检索中国知网、万方、PubMed、Embase等数据库中AIS出血转化预测模型的相关研究,检索时间为建库至2022年12月。对纳入文献进行质量评价,并依据数据提取清单提取资料。结果 共纳入27篇文献,包括30项出血转化风险预测模型,C统计量0.682～0.956,25项进行了内部验证,18项进行了外部验证。美国国立卫生院卒中量表(NIH Stroke Scale,NIHSS)、发病到开始治疗时间、年龄、血糖、收缩压是多变量风险预测模型中占比较高的独立预测因子。结论 已开发的风险预测模型具有良好的区分度,但模型偏倚风险较高。NIHSS评分、发病到治疗时间、血糖、年龄、血压是AIS出血转化的独立危险因素,有助于高危患者识别。
Abstract:
Objective To systematically evaluate the risk prediction models for hemorrhagic transformation(HT)in acute ischemic stroke(AIS),and to provide reference for the selection of clinical decision-making tools and the development of nursing risk assessment tools.Methods Databases including CNKI,Wanfang,PubMed,Embase and other databases were searched for studies on the prediction model of AIS HT from the inception to December 2022.The quality of the included literature was evaluated,and the data were extracted according to the data extraction checklist.Results A total of 27 articles were included,including 30 risk prediction models of HT.The C statistics were 0.682-0.956.25 models were internally validated,and 18 models were externally validated.The National Institutes of Health Stroke Scale(NIHSS),time from onset to treatment,age,blood glucose and systolic blood pressure were the independent predictors with high proportion in the multivariate risk prediction model.Conclusion The developed risk prediction models have good discrimination,but the risk of model bias is high.NIHSS score,time from onset to treatment,blood glucose,age and blood pressure are independent risk factors for HT of AIS,which are helpful to identify high-risk patients.

参考文献/References:

[1] FEIGIN V,BRAININ M,NORRVING B,et al.World stroke organization(WSO):global stroke fact sheet 2022[J].Int J Stroke,2022,17(1):18-29.
[2] WALTER K.What is acute ischemic stroke?[J/OL].[2023-02-14].https://jamanetwork.com/journals/jama/fullarticle/2789540.DOI:10.1001/jama.2022.1420.
[3] CAMPBELL B C V,KHATRI P.Stroke[J].Lancet,2020,396(10244):129-142.
[4] 马秀丽,黄叶莉,常红.急性缺血性脑卒中静脉溶栓患者护理质量评价指标体系的构建[J].解放军护理杂志,2020,37(8):24-27.
[5] LIU C,XIE J,SUN S,et al.Hemorrhagic transformation after tissue plasminogen activator treatment in acute ischemic stroke[J].Cell Mol Neurobiol,2022,42(3):621-646.
[6] 中华医学会神经病学分会,中华医学会神经病学分会脑血管病学组.中国急性脑梗死后出血转化诊治共识2019[J].中华神经科杂志,2019,52(4):252-265.
[7] MOONS K G,DE GROOT J A H,BOUWMEESTER W,et al.Critical appraisal and data extraction for systematic reviews of prediction modelling studies:the CHARMS checklist[J/OL].[2023-02-14].https://journals.plos.org/plosmedicine/article?id=10.1371/journal.pmed.1001744.DOI:10.1371/journal.pmed.1001744.
[8] WOLFF R F,MOONS K G M,RILEY R D,et al.PROBAST:a tool to assess the risk of bias and applica-bility of prediction model studies[J].Ann Intern Med,2019,170(1):51-58.
[9] REN Y,HE Z X,DU X Y,et al.The SON2A2 score:a novel grading scale for predicting hemorrhage and outcomes after thrombolysis[J/OL].[2023-02-14].https://www.frontiersin.org/articles/10.3389/fneur.2022.952843/full.DOI:10.3389/fneur.2022.952843.
[10]SONI M,WIJERATNE T,ACKLAND D.A risk score for prediction of symptomatic intracerebral haemorrhage following thrombolysis[J/OL].[2023-02-14].https://www.sciencedirect.com/science/article/pii/S1386505621002124?via%3Dihub.DOI:10.1016/j.ijmedinf.2021.104586.
[11]MENON B K,SAVER J L,PRABHAKARAN S,et al.Risk score for intracranial hemorrhage in patients with acute ischemic stroke treated with intravenous tissue-type plasminogen activator[J].Stroke,2012,43(9):2293-2299.
[12]LOKESKRAWEE T,MUENGTAWEEPONGSA S,PATUMANOND J,et al.Prediction of symptomatic intracranial hemorrhage after intravenous thrombolysis in acute ischemic stroke:the symptomatic intracranial hemorrhage score[J].J StrokeCerebrovasc Dis,2017,26(11):2622-2629.
[13]LOU M,SAFDAR A,MEHDIRATTA M,et al.The HAT Score:a simple grading scale for predicting hemorrhage after thrombolysis[J].Neurology,2008,71(18):1417-1423.
[14]STRBIAN D,ENGELTER S,MICHEL P,et al.Symptomatic intracranial hemorrhage after stroke thrombolysis:the SEDAN score[J].Ann Neurol,2012,71(5):634-641.
[15]MAZYA M,EGIDO J A,FORD G A,et al.Predicting the risk of symptomatic intracerebral hemorrhage in ischemic stroke treated with intravenous alteplase:safe implementation of treatments in stroke(sits)symptomatic intracerebral hemorrhage risk score[J].Stroke,2012,43(6):1524-1531.
[16]XIE X,YANG J,REN L,et al.Nomogram to predict symptomatic intracranial hemorrhage after in-travenous thrombolysis in acute ischemic stroke in asian population[J].Curr Neurovasc Res,2021,18(5):543-551.
[17]杨洁,谢小华,连万成,等.急性缺血性脑卒中静脉溶栓后出血预测模型的构建与验证[J].护理学报,2022,29(5):10-14.
[18]包建英,王雪梅,曹月洲,等.超时间窗急性缺血性脑卒中患者动脉取栓后颅内出血预警模型构建[J].南京医科大学学报:自然科学版,2021,41(12):1796-1800.
[19]吴月.AISrt-PA静脉溶栓后出血转化临床分析及预测模型的建立[D].昆明:昆明医科大学,2021.
[20]李鑫,李琼莉,王军伟,等.急性缺血性脑卒中静脉溶栓后出血转化的多因素联合预测模型研究[J].中华老年心脑血管病杂志,2021,23(4):430-432.
[21]杨瑞,鲁雪珍.老年急性缺血性脑卒中患者静脉溶栓后出血危险因素分析及预警模型构建[J].中国实用神经疾病杂志,2021,24(23):2054-2063.
[22]张冬,解战兵.高原地区急性脑梗死患者静脉溶栓后出血转化的因素分析及列线图预测模型构建[J].国际神经病学神经外科学杂志,2021,48(5):461-465.
[23]荆莉,沈延艳.急性脑梗死患者机械取栓后颅内出血的风险列线图预测模型[J].中国医师杂志,2021,23(3):366-369.
[24]梅丽,高勇,吕士英,等.急性脑梗死患者溶栓治疗后脑微出血风险预测列线图模型研究[J].实用心脑肺血管病杂志,2021,29(3):33-38.
[25]赵茂.急性脑梗死静脉rt-PA溶栓后出血转化风险预测模型建立的初步研究[D].遵义:遵义医科大学,2020.
[26]常红,赵洁,王晓娟,等.急性缺血性脑卒中患者静脉溶栓后出血预警模型的构建[J].中华护理杂志,2019,54(11):1648-1652.
[27]ZHANG K M,LUAN J F,LI C Q,et al.Nomogram to predict hemorrhagic transformation for acute ischemic stroke in Western China:a retrospective analysis[J/OL].[2023-02-10].https://bmcneurol.biomedcentral.com/articles/10.1186/s12883-022-02678-2.DOI:10.1186/s12883-022-02678-2.
[28]CUCCHIARA B,TANNE D,LEVINE S R,et al.A risk score to predict intracranial hemorrhage after re-combinant tissueplasminogen activator for acute ischemic stroke[J].J Stroke Cerebrovasc Dis,2008,17(6):331-333.
[29]BONKHOFF A K,RÜBSAMEN N,GREFKES C,et al.Development and validation of prediction models for severe complications after acute ischemic stroke:a study based on the stroke registry of Northwestern Germany[J/OL].[2023-02-10].https://www.ahajournals.org/doi/10.1161/JAHA.121.023175?url_ver=Z39.88-2003&rfr_id=ori:rid:crossref.org&rfr_dat=cr_pub%20%200pubmed.DOI:10.1161/JAHA.121.023175.
[30]QIAN Y,QIAN Z T,HUANG C H,et al.Predictive factors and nomogram to evaluate the risk of symptomatic intracerebral hemorrhage for stroke patients receiving thrombectomy[J].World Neurosurg,2020,144:e466-e474.
[31]WU Y,CHEN H,LIU X,et al.A new nomogram for individualized prediction of the probability of hemorrhagic transformation after intravenous thrombolysis for ischemic stroke patients[J/OL].[2023-02-10].https://bmcneurol.biomedcentral.com/articles/10.1186/s12883-020-02002-w.DOI:10.1186/s12883-020-02002-w.
[32]CAPPELLARI M,MANGIAFICO S,SAIA V,et al.IER-SICH nomogram to predict symptomatic intracerebral hemorrhage after thrombectomy for stroke[J].Stroke,2019.50(4):909-916.
[33]CAPPELLARI M,TURCATO G,FORLIVESI S,et al.STARTING-SICH nomogram to predict symptomatic intracerebral hemorrhage after intravenous thrombolysis for stroke[J].Stroke,2018,49(2):397-404.
[34]WENG Z A,HUANG X X,DENG D,et al.A new nomogram for predicting the risk of intracranial hemorrhage in acute ischemic stroke patients after intravenous thrombolysis[J/OL].[2023-02-10].https://www.frontiersin.org/articles/10.3389/fneur.2022.774654/full.DOI:10.3389/fneur.2022.774654.
[35]YANG M,ZHONG W,ZOU W,et al.A novel nomogram to predict hemorrhagic transformation in ischemic strokepatients after intravenous thrombolysis[J/OL].[2023-02-10].https://www.frontiersin.org/articles/10.3389/fneur.2022.913442/full.DOI:10.3389/fneur.2022.913442.
[36]COLLINS G S,REITSMA J B,ALTMAN D G,et al.Transparent reporting of a multivariable prediction model for individual prognosis or diagnosis(TRIPOD):the TRIPOD statement[J].BMJ,2015,162(1):55-63.
[37]MAN S,XIAN Y,HOLMES D N,et al.Association between thrombolytic door-to-needle time and 1-year mortalityand readmission in patients with acute ischemic stroke[J].JAMA,2020,323(21):2170-2184.
[38]DESILLES J P,SYVANNARATH V,OLLIVIER V,et al.Exacerbation of thromboinflammation by hyperglycemia precipitates cerebral infarct growth and hemorrhagic transformation[J].Stroke,2017,48(7):1932-1940.
[39]DARGER B,GONZALES N,BANUELOS R C,et al.Outcomes of patients requiring blood pressure control before thrombolysis with tpa for acute ischemic stroke[J].West J Emerg Med,2015,16(7):1002-1006.
[40]PUNDIK S,WILLIAMS L,BLACKHAM K L,et al.Older age does not increase risk of hemorrhagic complications after intravenous and/or intraarterial thrombolysis for acute stroke[J].J Stroke Cerebrovasc Dis,2008,17(5):266-272.
[41]WEI C,LIU J,GUO W,et al.Development and validation of a predictive model for spontaneous hemorrhagic transformation after ischemic stroke[J/OL].[2023-01-20].https://www.frontiersin.org/articles/10.3389/fneur.2021.747026/full.DOI:10.3389/fneur.2021.747026.

备注/Memo

备注/Memo:
【收稿日期】2023-02-14【修回日期】2023-09-25
【基金项目】江苏省科技计划(资金)项目(BE2022668); 中华护理学会科研课题专项资助(ZHKYQ202108)
【作者简介】崔梦娇,硕士在读,电话:025-83106666
【通信作者】陈璐,电话:025-83106666
更新日期/Last Update: 2023-10-15