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1、缺血性卒中病因分型法在中国卒中人群应用效果比较分类号：R743文献标识码：A文章编号：1009一816X(2010)02一0088一03ComparativeStudyofTwoEtiologicalClassificationsofIschemicStrokeinChineseStrokePatients.HANZhao,ZANGQiuJ.ing，WANGPing_li,etal.DivisionofStrokeMedicine,FirstAffiliatedHospital,WenzhouMe
2、dicalCollege,Zhejiang325000,China[Abstract]0bjectiveToevaluateinter_investigatoragreementbetweenTOASTClassificationproposedbyAdamsetalin1993andanewClassificationproposedbySangWonHanetalin2007andtostudythedifferenceoftheproportionforeachsubtypeinChines
3、eischemicstrokepatientsdiagnosedbythetwoClassificationsrespectively.Methods395Consecutivecaseswithacuteischemicstrokewereenrolledinthisstudy,theiretiologicalsubtypeswerediagnosedatdischargebyoneneurologistaccordingtothetwoClassificationsandx2testwasus
4、edtocomparethedifferenceoftheproportionforeachsubtype.Meanwhile,twoneurologistsindependentlydiagnosedsubtypeof20casesselectedrandomlyandKappaanalysiswasusedtoevaluateinter_investigatorsagreement.Results(1)Twoinvestigatorshaveagreementwiththestrokesubt
5、ypediagnosisin17outof20casesbyTOASTcriteria(k=0.78)andin18outof20casesbySangWonHanetalnewclassificationsystem(k=0.93).(2)AccordingtoTOASTclassification,theconstituentratioofsubtypesforallenrolledcaseswasasfollowing：strokeofundeterminedetiology39.0%,Sm
6、all_arterydisease29.6%,Large_arteryatherosclerosis21.3%,cardioembolism8.9%,Strokeofotherdeterminedcause1.3%；BythenewelassificationsystemofSangWonHan,theconstituentratiosubtypeswasasfoliowing：atherothrombosis44.6%,Strokeofundeterminedetiology25.1%,smal
7、l_arterydisease23.3%,cardioembolism5.8%,strokeofotherdeterminedcause1.3%.ConclusionsBothofthetwoclassificationshaveexcellentagreement.ComparedwithTOASTclassification,thenewclassificationproposedbySangWonHanhashigheragreementandlessproportionofStrokeof
8、undeterminedetiology,andtheproportionofatherothrombosistypeincreased.［Keywords］Ischemicstroke；TOASTclassification；Constituentratio；Agreement不同病因的缺血性脑卒中患者，其治疗和二级预防的策略不同［1］。目前国际上应用较多的缺血性脑卒中的病因分型是1993年Adams等在类肝素药物0RG10172治疗急性卒中(TheTrialof0rgl0172
