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目的探讨缺血性脑卒中CISS分型的应用价值。方法选取2012年4月—2013年4月我院收治的缺血性脑卒中患者340例,由科内两位副主任医师进行盲法CISS分型及TOAST分型,对分型不一致的患者交由全科讨论后确定。比较两种分型法各亚型的构成比、差异。结果 CISS分型中大动脉粥样硬化型(LAA)比例高于TOAST分型(P<0.05)。两种分型法共有155例(45.6%)患者的分型发生变化,其中CISS分型中LAA增加79例,分别来自TOAST分型中的小动脉闭塞型(SAO)41例,不明病因型(SUE)34例,心源性栓塞型(CE)4例。颅内外大动脉粥样硬化机制分型的构成比例依次为:载体动脉(斑块或血栓)阻塞穿支动脉116例(47.9%),动脉到动脉栓塞52例(21.5%),低灌注/栓子清除下降51例(21.1%),混合机制23例(9.5%)。结论 CISS分型与TOAST分型具有较高的一致性。与TOAST分型相比,CISS分型在反映缺血性脑卒中的病因及发病机制方面更准确,更有利于疾病防治。
Objective To investigate the value of CISS classification in ischemic stroke. Methods From April 2012 to April 2013, 340 patients with ischemic stroke admitted to our hospital were selected and divided into two groups according to blind CISS classification and TOAST classification by two deputy chief physicians. The patients with inconsistent typing Determined by the general discussion. Compare the two subtypes of subtypes of the composition ratio, differences. Results The proportion of large atherosclerotic lesions (LAA) in CISS was higher than that in TOAST (P <0.05). A total of 155 patients (45.6%) underwent the two classification methods. The type of LAA in CISS was increased by 79 cases, from 41 cases of arteriolar occlusion type (TOA), 41 cases of unknown type 34 cases of SUE and 4 cases of cardioembolism (CE). The proportions of intracranial and extra-aortic atherosclerosis were 116 (47.9%) with arterial embolism (plaque or thrombus), 52 (21.5%) with arterial embolism, low perfusion / embolism Clear reduction in 51 cases (21.1%), mixed mechanism in 23 cases (9.5%). Conclusion The CISS classification is highly consistent with TOAST classification. Compared with the TOAST classification, CISS classification is more accurate in reflecting the etiology and pathogenesis of ischemic stroke, and more conducive to disease prevention and treatment.