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目的:探讨急诊脑卒中识别评分量表(ROSIER)在院前急救筛选中的应用价值。方法:收集2013年1月至2014年1月期间,我院急诊科收治的可疑脑卒中病例114例,在院前急救中应用ROSIER量表筛查,并以辛辛那提院前脑卒中识别评分量表(CPSS)作为对照,以头颅CT或MRI检查、神经专科医师意见作为最终诊断,比较ROSIER与CPSS的对于脑卒中的筛选价值。结果:ROSIER对脑卒中的特异度、阳性似然比依次为83.67%、4.80,均显著高于CPSS的67.35%、2.36(P<0.05);假阳性为16.33%,显著低于CPSS的32.65%;ROSIER的Kappa值为0.621,显著高于CPSS的0.462,差异具有统计学意义(P<0.05);两组的敏感度、假阴性率及阴性拟然比无明显差异(P>0.05)。结论:ROSIER应用于脑卒中筛查具有较高的敏感度和特异度,对于脑卒中的院前筛查以及院前急救具有重要指导意义。
Objective: To explore the value of ROSIER in the screening of pre-hospital emergency care. Methods: From January 2013 to January 2014, 114 cases of suspicious stroke admitted to emergency department of our hospital were collected. The ROSIER scale was used in pre-hospital emergency and screened by Cincinnati Hospital stroke score (CPSS) as a control, skull CT or MRI, neurologist opinion as the final diagnosis, comparing ROSIER and CPSS screening of stroke. Results: The specificity of ROSIER for stroke was 83.67% and 4.80, respectively, which were significantly higher than those of CPSS 67.35% and 2.36 (P <0.05). The false positive rate was 16.33%, significantly lower than that of CPSS 32.65% ; ROSIER Kappa value of 0.621, significantly higher than CPSS 0.462, the difference was statistically significant (P <0.05); the two groups of sensitivity, false negative rate and negative quasi-no significant difference (P> 0.05). CONCLUSIONS: ROSIER has high sensitivity and specificity for stroke screening. It has important guiding significance for pre-hospital screening of stroke and pre-hospital emergency.