摘要
目的评价急性脑梗死患者的红细胞分布宽度(RDW)和神经功能评分的关系及其对患者短期(3个月)预后的判断价值。方法收集本院神经内科急性发病的脑梗死患者90例作为研究组(均为非溶栓患者),同时把本院神经内科急性入院的眩晕症、血管性紧张性头痛等就诊的非脑梗死患者53例作为对照组;对入组患者进行常规、血常规及血生化检查,同时对入组脑梗死患者的行美国国立卫生研究院卒中量表(NIHSS)评分,并根据NIHSS水平进行分组:轻度、中度和重度;对2组患者一般临床资料进行比较,同时比较2组患者及NIHSS不同评分组的RDW值的差异,评价RDW和NIHSS评分的相关性。对入组的脑梗死患者进行脑梗死发生后3个月随访,评定患者的改良Ranking量表(mRS)评分情况,对mRS评分进行分组,即预后良好组(mRS≤2)和预后不良组(mRS>2分),比较2组的RDW值,同时采用多因素Logistic分析其预后不良的危险因素。结果脑梗死组的RDW较对照组明显增高(P<0.01);RDW的中位值随着神经功能缺损程度的加重而增高(P<0.05);相关性分析显示RDW与NIHSS评分呈正相关(r=0.335 P=0.001);预后不良组的RDW较预后良好组明显增高(P<0.01);多因素Logistic分析显示高RDW、NIHSS及2型糖尿病是急性脑梗死患者短期不良预后的危险因素。受试者工作特征(ROC)曲线图显示RDW对急性脑梗死患者不良预后预测的最佳界值为14.2%(敏感度,72.8%;特异性,68.6%;准确性,71.2%)。结论急性脑梗死患者早期的RDW对评估患者的严重性及短期预后有一定价值。
Objective The aim is to investigate the value of red blood cell distribution width （RDW） on the evaluation of neurological deficit scores and short-term（3months） prognosis in patients with acute ischemic stroke. Methods 90 cases of acute cerebral infarction patients（none with thrombolytic treatment） in the Department of Neurology of our hospital were considered as the study group. At the same time, 53 cases of noncerebral infarction patients who suffered from vertigo, vascular tension headaches and others were considered as the control group. All subjects had regular blood tests and blood biochemical examination. Stroke patients had National Institute of Health Stroke Scale（NIHSS）scores, and they were rated as mild, moderate and severe based on NIHSS score. General clinical data of 2 groups of patients were compared and so as the difference of RDW of all the patients. The difference of RDW values between the two groups were compared. The correlation beteen the RDW values and NIHSS score was investigated. Patients in the cerebral infarction group received 3 months follow-up and evaluated by modified Ranking scale （mRS） score. According to the mRS scores, the pa- tients were grouped by good prognosis group （mRS 2 or less） and poor prognosis group （mRS 〉 2） and the difference of RDW values beteen the two groups was compared. At the same time, the risk factors of short-term poor prognosis were analyzed by multivariate Logistic regression analysis. Results Stroke patients had signifi- cantly higher median RDW than control subjects（P〈0. 01）. The median RDW values significantly elevated in patients who had more severe strokes rated by NIHSS（P〈0. 05）. Correlation analysis showed the RDW val-ues had positive correlation with NIHSS scores（r= 0. 335 P = 0. 001）. The RDW values in the poor prognosis group were significantly higher than that in the good prognosis group（P^0. 01）. The multivariate Logistic re- gression analysis showed that high RDW values and NIHSS and type 2 di
作者
葛永春
赵合庆
Ge Yongchun Zhao Heqing(Department of Neurology, Affiliated Liyang People ＇ s Hosptal of Nantong University ,Liyang 213300)
出处
《卒中与神经疾病》
2016年第6期438-442,共5页
Stroke and Nervous Diseases
关键词
急性脑梗死
红细胞分布宽度
预后
Acute cerebral infarction
Red blood cell distribution width
Prognosis
