Objective To develop a predictive index for symptomatic vasospasm after subarachnoid hemorrhage (SAH). Methods Seventy- one patients diagnosed as aneurysmal SAH (aSAH) by computed tomography underwent transcranial Doppler (TCD) examinations. The middle cerebral artery velocity (MCAV), internal carotid artery velocity (ICAV), Lindegaard ratios and va-sospasm index (VI) were obtained. The clinical data including age, sex, Hunt and Hess grade, Fisher grade, treatment (coil em-bolization, surgical clip occlusion, or conservative treatment), smoking history and hypertension history were documented. Sensi-tivity, specificity, predictive values, and overal accuracy rate of the different tests were calculated. Logistic regression was used to evaluate the predictive factors, and the coefficients of the logistic regression were integrated to develop the vasospasm pre-dictive index (VPI). Results Twenty one out of 71 patients (29.6%) developed symptomatic vasospasm after aSAH. Taking MCAV>120 cm/sec as cut- off value, the overal accuracy rate of MCAV was 80.3%for the diagnosis of clinical vasospasm;Lin-degaard ratio>3.0 as cut- off, the overal accuracy was 81.7%and VI>3.5 as cut- off the overal accuracy was 84.5%. A VPI was developed with the combination of Fisher grade, MCAV and VI;and the overal accuracy rate of the established VPI was 94.4%for clinical vasospasm detection. Conclusion The vasospasm predictive index developed in this study is superior to individual tests, which can be used to predict cerebral vasospasm after aneurysmal SAH clinical y.%目的：建立一个用来提高动脉瘤性蛛网膜下腔出血（aSAH）后症状性脑血管痉挛（CVS）诊断准确率的综合性血管痉挛预测指数（VPI）。方法选取71例确诊为aSAH的患者为研究对象，在发病后72h内行经颅多普勒超声检查，获得颅内大脑中动脉流速（MCAV）、颈内动脉血流速度、Lindegaard率、颅内血管痉挛指数（VI）；收集患者的临床特征：年龄、性别、Hunt- Hess分级、CT Fisher分级、WBC计数、治疗方法（弹簧圈栓塞、外科夹闭或保守治疗），吸烟史、高血压病史；同时观察患者有无症状性CVS发生。用SPSS统计软件进行统计学分析，logistic回归分析评估血管痉挛的预测模型，建立回归方程，得出VPI。结果21例（29.6%）发生CVS。MCAV＞120cm/s，CVS的诊断准确率为80.3%。Lindegaard率＞3.0时，CVS的诊断准确率为81.7%。VI＞3.5时，CVS的诊断准确率为84.5%。以CT Fisher分级、MCAV、VI为危险因素得出的VPI诊断CVS准确率为94.4%。结论 VPI与以往单独的预测因素比较，能显著提高诊断CVS的准确率，可作为临床医师用来评估aSAH之后患者发生CVS的有用工具。
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