Padua量表与Wells量表对脑卒中并发深静脉血栓形成预测效果的对比分析
Comparison of predictive power of Padua Scale and Wells Scale on stroke complicated with deep venous thrombosis
摘要目的? 比较Padua量表与Wells量表对脑卒中患者DVT的预测能力.方法? 采用方便抽样法,收集2016年11月—2017年11月于北京大学第三医院院神经内科住院治疗的脑卒中患者300例患者作为研究对象,同时使用Padua量表和Wells量表进行评估,以深静脉彩色多普勒超声检查结果为是否发生血栓的标准,评价2种量表对脑卒中DVT预测能力;同时构建受试者工作特征曲线(ROC曲线)模型,比较2种量表的灵敏度、特异度、ROC曲线下面积(AUC),并计算出2个量表的阳性预测值、阴性预测值.结果? 2个量表均可预测脑卒中后DVT的风险(P<0.01).Padua量表、Wells量表的AUC分别为0.802(95%CI=0.704~0.900)、0.746(95%CI=0.642 ~0.851),最佳切点的Padua量表、Wells量表的灵敏度分别为80.00%、64.00%,特异度分别为58.18%、77.82%,计算得出的阳性预测值分别为14.81%、20.78%,阴性预测值分别为96.96%、95.96%.结论? Padua量表更适合用于脑卒中患者下肢深静脉血栓的风险预测.
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abstractsObjective? To compare the predictive power of Padua Scale and Wells Scale on stroke complicated with deep venous thrombosis (DVT). Methods? Totally 300 patients with stroke admitted in the Department of Neurology, Peking University Third Hospital from November 2016 to November 2017 were selected by convenient sampling and investigated with Padua Scale and Wells Scale. The incidence of DVT was determined according to color Doppler ultrasonography for deep veins. The predictive power of the two scales on stroke complicated with DVT was evaluated; and the Receiver Operating Characteristic (ROC) model was established to compare the sensitivity, specificity and area under the ROC (AUC). The positive and negative predictive values of the two scales were calculated. Results? Both scales could predict the risks of stroke complicated with DVT (P<0.01). The AUC of Padua Scale and Wells Scale was 0.802 (95%CI=0.704-0.900) and 0.746 (95%CI=0.642-0.851). The sensitivity of Padua Scale and Wells Scale at the best cutoff value was 80.00% and 64.00%, and their specificity was 58.18% and 77.82%. Their positive predictive values were 14.81% and 20.78%, and their negative predictive values were 96.96% and 95.96%. Conclusions? Padua Scale is more suitable for predicting the risk of DVT in lower extremities of patients with stroke.
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