| 摘要: |
| 目的:对我国脑卒中患者临床神经功能缺损评分标准(CSS)的信度、效度和敏感度进行研究，评价其临床应用价值。方法:根据纳入标准，选取我院神经内科的126例脑卒中患者，分别用CSS和美国国立卫生研究院卒中量表(NIHSS)对其进行评分，并对CSS进行信度、效度、敏感度评价。信度用相关系数r和Cronbach’s α系数来评价。结构效度采用聚类因子分析方法考核；效标效度以NIHSS量表为效标，应用相关系数分析。各维度敏感度通过标准化效应(SES)来评估。结果:共收回有效问卷123份。CSS有良好的信度，各维度的重测信度和评定者间信度均在0.911～1.000；内部一致性信度的Cronbach’s α系数均在0.8以上。CSS有较好的结构效度；分析CSS与NIHSS间相关系数为0.86，效标效度良好。预后预测CSS准确率为92.4%，稍低于NIHSS的预测准确率94.1%；Logistic回归显示CSS的“凝视功能”和“面瘫”项目未能归入预测方程；除面瘫项目SES为0.38外，其他均大于0.5，大多数维度均显示出了良好的敏感性。结论:经初步测试，CSS在脑卒中患者中具有较好的信度、效度、敏感度，但预测预后不及NIHSS，修订时可作相应调整。 |
| 关键词: 脑血管意外 临床神经功能缺损评分标准 信度 效度 敏感度 |
| DOI：10.3724/SP.J.1008.2009.0283 |
| 投稿时间：2008-07-20修订日期：2008-09-24 |
| 基金项目: |
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| Reliability, validity and sensitivity of Chinese scale for clinical neurological deficit of stroke patients |
| TAO Zi-rong |
| (Department of Neurosurgery, Xiangya Hospital, Central South University, Changsha 410008, China) |
| Abstract: |
| Objective:To investigate the reliability, validity and sensitivity of Chinese scale of clinical neurological deficit of stroke patients (China Stroke Scale, CSS), so as to assess its clinical application value.Methods: A total of 126 consecutive inpatients with acute stroke onset were included in our study and they were scored by CSS and the United States National Institutes of Health Stroke Scale (NIHSS) score separately; the reliability, validity, and sensitivity of CSS were evaluated. Reliability was evaluated by correlation coefficient r and Cronbach’s α coefficient; construct validity was analyzed by factor analysis method of appraisal; criterion validity was analyzed by the correlation coefficient analysis with NIHSS scale as the criterion. Sensitivity in various fields was assessed through standardization of effect (SES).Results: Totally 123 valid questionnaires were collected. CSS showed high intrarater reliability, interrater reliability (0.911-1.000) and good internal consistency, with the Cronbach’s α>0.8. There was concurrent validity between CSS and NIHSS (r=0.86). The prognosis prediction accuracy of CSS was 92.4%, slightly lower than that of NIHSS (94.1%). Logistic regression showed that CSS’s “gaze function” and “facial paralysis” were not included in the prediction equation. The facial paralysis had a SES of 0.38, all others had a SES higher than 0.5. Most fields showed a good sensitivity.Conclusion: CSS shows an acceptable reliability, validity and sensitivity in patients with stroke, but the predicative validity of CSS is inferior to that of NIHSS, which needs be further revised. |
| Key words: cerebrovascular accident Chinese Scale of Clinical Neurologic Deficit reliability validity sensitivity |
