摘要
目的探讨动脉瘤性蛛网膜下腔出血(aSAH)患者C反应蛋白(CRP)水平和世界神经外科联盟(WFNS)分级系统的预后价值。方法入选aSAH患者69例作为研究组,同时入选72例健康体检者作为对照组。检测所有纳入对象CRP水平,记录aSAH患者WFNS分级。所有aSAH患者随访至死亡或发病后6个月,根据格拉斯哥预后量表分为预后不良组(<4分)与预后良好组(≥4分)。比较两组患者的CRP水平和WFNS评分,并分析两者在预测aSAH患者预后的价值。结果研究组CRP水平明显高于对照组(t=-11.19,P<0.05);预后不良组CRP水平、WFNS分级明显高于预后良好组,GCS评分低于预后良好组(t=-5.31,Z分别=-4.51、-4.03,P均<0.05)。CRP、WFNS分级预测aSAH患者6个月不良预后的ROC曲线下面积分别为0.82(95%CI 0.71~0.92,P<0.05)、0.82(95%CI 0.72~0.92,P<0.05),而两者联合诊断aSAH患者6个月不良预后的预测价值更高,其ROC曲线下面积为0.90(95%CI 0.82~0.98,P<0.05)。结论CRP水平联合WFNS分级系统在预测aSAH患者的不良预后中具有更高的临床价值。
Objective To analyze the prognostic value of the serum C-reactive protein(CRP)levels and the world federation of neurological surgeons(WFNS)scale in patients with aneurysmal subarachnoid hemorrhage(aSAH).Meth⁃ods Totally 69 patients with aSAH were enrolled in the study group and 72 healthy people as the control group.The serum CRP levels of all objects were detected,and the WFNS scale of the patients with aSAH were recorded.All aSAH patients were followed up for 6 months or till death,and they were divided into poor prognosis group(<4 scores)and good prognosis group(≥4 scores)according to the glasgow outcome scale score.The serum CRP levels and the WFNS score of the two groups were compared,and the prognostic values of the CRP levels and the WFNS score in aSAH patients were analyzed.Results The level of CRP in the study group was significantly higher than the control group(t=-11.19,P<0.05).The level of CRP and WFNS score in the poor prognosis group were significantly higher than those in the good prognosis group,the GCS score was significantly lower than good prognosis group(t=-5.31,Z=-4.51,-4.03,P<0.05).The areas under receiver operating characteristic curve(ROC)of CRP and the WFNS scale for predicting the 6-month poor prognosis of aSAH patients were 0.82(95%CI 0.71-0.92,P<0.05)and 0.82(95%CI 0.72-0.92,P<0.05)respectively,while CRP combined with the WFNS scale had a higher predictive value with an area under ROC of 0.90(95%CI 0.82-0.98,P<0.05).Conclusion Serum CRP combined with the WFNS scale has a better clinical value in predicting the poor prognosis of aSAH patients.
作者
郑永科
顾南媛
裘凯
潘璐
曾龙欢
ZHENG Yongke;GU Nanyuan;QIU Kai(Department of Intensive Care Unit,Affiliated Hangzhou First People’s Hospital,Zhejiang University School of Medicine,Hangzhou 310006,China)
出处
《全科医学临床与教育》
2021年第4期297-300,共4页
Clinical Education of General Practice
基金
浙江省医药卫生科技计划项目(2018KY586)。
关键词
动脉瘤性蛛网膜下腔出血
不良预后
C反应蛋白
WFNS分级系统
aneurysmal subarachnoid hemorrhage
poor prognosis
C-reactive protein
world federation of neurological surgeons scale
