摘要
目的探讨脑梗死患者急性期血清胆红素与TOAST分型及预后情况的相关性。方法 153例急性缺血性卒中患者按照TOAST分型方法分为五型,另外选取40例同期门诊健康体检成人作为对照组。比较脑梗死患者与对照组血清胆红素水平的差异,及不同TOAST分型脑梗死患者血清胆红素水平的差异。所有脑梗死患者治疗前采用美国国立卫生研究院卒中量表(NIHSS)进行评分,分析血清胆红素水平与脑梗死严重程度间的关系,治疗14 d后按照改良的RANKIN量表(mRS)进行评分,分析血清胆红素水平与患者预后的关系。结果脑梗死患者总胆红素(TBIL)和间接胆红素(IBIL)水平均明显高于健康组(P<0.05)。心源性脑栓塞(CE)患者血清TBIL和IBIL水平低于其他各组。患者脑梗死严重程度与各种血清胆红素水平无关,但预后不良组血清TBIL低于预后良好组(P<0.05)。结论脑梗死急性期血清TBIL和IBIL水平可能对脑梗死TOAST分型具有鉴别作用,尤其是对心源性脑梗死患者具有重要提示作用。另外,血清TBIL与短期预后可能相关,表现为血清TBIL水平越低,患者短期预后效果越差。
Objectiye To analyze the relationship between serum bilirubin and TOAST subtypes with acute ischemic stroke and early -term prognosis. Methods According to TOAST criteria,153 patients with acute ischemic stroke were classified. 40 healthy patients in our hospi-tal physical examination centre in same time were selected as control group. To compare the differences of the serum bilirubin level between case groups and health group. Among five TOAST subtypes,NIHSS was adopted to evaluate the severity of stroke before treatment. At 14th day after treatment,mRS was adopted to evaluate the early - term prognosis. Results The level of serum total bilirubin（ TBIL）and indirect bilirubin （IBIL）in the case groups were higher than that in the control group（ P 〈 0. 05）. Meanwhile,the serum TBIL and IBIL level were significantly higher in patients with subtype CE comparing with others subtypes. The serum bilirubin level has no correlation with the severity of stroke. Howev-er,the serum TBIL level in good prognosis group was higher than that in poor prognosis group（ P 〈 0. 05）. Conclusion For the patients with acute ischemic stroke,the serum TBIL and IBIL level could help to distinguish the TOAST subtypes,especially for subtype CE. Moreover,the se-rum TBIL level may correlates with early - term prognosis. The higher the level is,the worse the prognosis is.
出处
《临床和实验医学杂志》
2016年第16期1580-1582,共3页
Journal of Clinical and Experimental Medicine
