摘要
目的:探讨同型半胱氨酸(Hcy)、C反应蛋白(CRP)及游离脂肪酸(NEFA)水平预测老年缺血性卒中患者预后的临床价值。方法:回顾性分析我院188例老年缺血性卒中患者的临床资料,随访3个月,其中预后良好136例(预后良好组)、预后不良52例(预后不良组),对两组基线资料进行单因素及多因素Logistic回归分析,绘制ROC曲线评价Hcy、CRP、NEFA对急性缺血性卒中预后的预测价值。结果:预后不良组高血压史、糖尿病史占比及空腹血糖(FBG)、糖化血红蛋白(HbA1c)、Hcy、CRP、NEFA水平均显著高于预后良好组(P均<0.01)。Logistic多因素回归分析结果显示,糖尿病史、Hcy、CRP、NEFA是急性缺血性卒中预后的独立危险因素(OR=3.501~5.270,P均=0.001)。Hcy预测预后的ROC曲线下面积为0.830,最佳截断值为17.950,此时敏感度为0.615,特异度为0.882。CRP预测预后的ROC曲线下面积为0.805,最佳截断值为1.395,此时敏感度为0.731,特异度为0.735。NEFA预测预后的ROC曲线下面积为0.723,最佳截断值为0.485,此时敏感度为0.615,特异度为0.706。结论:同型半胱氨酸、C反应蛋白及游离脂肪酸是急性缺血性卒中预后的独立危险因素,均对急性缺血性卒中预后有一定预测价值。
Objective： To explore predictive value of homocysteine （Hcy）, C reactive protein （CRP） and non- esteri- fled fatty acid （NEFA） levels for prognosis of aged patients with ischemic stroke. Methods： Clinical data of 188 aged patients with ischemic stroke from our hospital were retrospectively analyzed. After threemonth follow-up, pa- tients were divided into good prognosis group （n = 136） and poor prognosis group （n = 52） according to their progno- sis. Baseline data of two groups received singlefactor and multifactor Logistic regression analysis. ROC curve was drawn to evaluate the predictive value of Hcy, CRP and NEFA levels for prognosis of acute ischemic stroke. Resuits ： Compared with good prognosis group, there were significant rise in percentages of hypertension, diabetes mel- litus （DM） history, levels of fasting blood glucose （FBG）, glycosylated hemoglobin Alc （HbAlc）, Hcy, CRP and NEFA in poor prognosis group, P〈0.01 all. Multi-factor Logistic regression analysis indicated that DM history, Hcy, CRP and NEFA were independent risk factors for prognosis of acute ischemic stroke （OR = 3. 501-5. 270, P = 0. 001 all）. Area under the ROC curve （AUC） of Hcy predicting prognosis was 0. 830, the optimal cutoff value was 17. 950 with sensitivity = 0. 615 and specificity = 0. 882. AUC of CRP predicting Prognosis was 0. 805, the optimal cutoff value was 1.395 with sensitivity = 0. 731 and specificity = 0. 735. AUC of NEFA predicting prognosis was 0. 723, the optimal cutoff value was 0. 485 with sensitivity = 0. 615 and specificity = 0. 706. Conclusion： Homo- cysteine, C reactive protein and non- esterified fatty acid are independent risk factors for prognosis of acute ische- mic stroke, which possess certain predictive value for prognosis of acute ischemic stroke.
出处
《心血管康复医学杂志》
CAS
2018年第1期1-4,共4页
Chinese Journal of Cardiovascular Rehabilitation Medicine
