摘要
目的研究缺血性脑卒中患者发生脑微出血(CMBs)的危险因素,分析血清胱抑素C(CysC)、中性粒细胞/淋巴细胞比值(NLR)与CMBs的关系。方法选取2017年1月—2020年2月安徽省芜湖市第一人民医院接收的80例缺血性脑卒中患者,根据患者是否出现CMBs分为CMBs组(33例)和非CMBs组(47例)。比较两组基线资料和生化指标的差异,分析CMBs的危险因素及CysC和NLR对CMBs的预测价值。结果CMBs组年龄和高血压病史率均高于非CMBs组(均P<0.05)。CMBs组空腹血糖(FBG)、NLR和CysC水平均高于非CMBs组(均P<0.05)。高年龄、具有高血压病史、高NLR和高CysC水平均为CMBs的独立危险因素(均P<0.05)。对CMBs发生的预测诊断的受试者工作特征(ROC)曲线分析结果显示,NLR理论阈值为2.60,灵敏度为80.2%,特异度为73.9%,曲线下面积(AUC)为0.727(P<0.05);血清CysC水平的理论阈值为1.19 mg/L,灵敏度为82.6%,特异度为71.8%,AUC为0.758(P<0.05)。两指标联合应用的诊断效能更高:灵敏度为84.2%,特异度为85.0%,AUC为0.845(P<0.05)。结论高龄、具有高血压病史、高血清CysC水平及高NLR的缺血性脑卒中患者发生CMBs的风险更高,血清CysC水平及NLR可作为CMBs发生的敏感指标。
Objective To study the risk factors of cerebral microbleeds(CMBs)in patients with ischemic stroke and to analyze the relationship between serum cystatin C(CysC),neutrophil/lymphocyte ratio(NLR)and CMBs.Methods A total of 80 patients with ischemic stroke admitted to Wuhu NO.1 People’s Hospital,Anhui Province from January 2017 to February 2020 were selected and divided into CMBs group(33 cases)and non-CMBs group(47 cases)according to the occurrence of CMBs.The differences of baseline data and biochemical indexes were compared between the two groups.The risk factors of CMBs and predictive value of CysC and NLR for CMBs were analyzed.Results The age and hypertension history rate in CMBs group were significantly higher than non-CMBs group(all P<0.05).The fasting blood-glucose(FBG),NLR and CysC levels of the CMBs group were higher than those of the non-CMBs group(all P<0.05).High age,with history of hypertension,high NLR,and high CysC levels were all independent risk factors for CMBs(all P<0.05).The receiver operating characteristic(ROC)curve analysis for the prediction and diagnosis of CMBs showed that the theoretical threshold of NLR was 2.60,the sensitivity was 80.2%,the specificity was 73.9%,and the area under curve(AUC)was 0.727(P<0.05).The theoretical threshold of serum CysC level was 1.19 mg/L,the sensitivity was 82.6%,the specificity was 71.8%,and the AUC was 0.758(P<0.05).The combined application of the two indexes had higher diagnostic efficiency:the sensitivity was 84.2%,the specificity was 85.0%,and the AUC was 0.845(P<0.05).Conclusion Elderly patients with ischemic stroke who have a history of hypertension,high serum CysC level,and high NLR may be at higher risk of CMBs.Serum CysC level and NLR can be used as sensitive indicators for CMBs occurrence.
作者
张多斌
陈后勤
蔡红星
左健
ZHANG Duobin;CHEN Houqin;CAI Hongxing;ZUO Jian(Department of Neurology,Wuhu NO.1 People’s Hospital,Anhui Province,Wuhu241000,China)
出处
《中国医药导报》
CAS
2020年第35期38-41,共4页
China Medical Herald
基金
安徽省自然科学基金项目(1608085QH238)。
