摘要
目的 探讨血管细胞黏附因子-1(VCAM-1)联合Fazekas评分对合并脑白质疏松的急性脑梗死(ACIL)患者发病后90 d转归的预测价值。方法 选取2020年8月—2021年10月安徽医科大学附属宿州医院收治的首次发病NIHSS评分为8分的ACIL患者96例为研究对象。采用酶联免疫吸附法(ELISA)检测血清VCAM-1水平,并对ACIL患者进行Fazekas评分。根据改良的Rankin量表(m RS)评价患者发病后90 d的预后情况,m RS≤2分为预后良好(70例),m RS≥3分为预后不良(26例)。采用ROC曲线分析血清VCAM-1联合Fazekas评分对ACIL患者预后的评估价值。结果 与预后良好组比较,预后不良组患者年龄[(71.23±3.66)岁vs.(64.57±5.24)岁]、血清VCAM-1[2.66(2.48,2.78) ng/mL vs. 2.10(1.40,2.23) ng/mL]、Fazekas评分[4(4,5)分vs. 3(2,3)分]显著升高(均P<0.05)。多因素logistic回归分析显示年龄大、VCAM-1升高及Fazekas评分升高是预后不良的独立危险因素。ROC曲线分析结果显示血清VCAM-1联合Fazekas评分评估预后不良的灵敏度为92.31%,特异度为94.29%。结论 血清VCAM-1联合Fazekas评分对ACIL患者发病后90 d转归具有较高的预测价值。
Objective To explore the predictive value of serum vascular cell adhesion molecule 1(VCAM-1)level combined with Fazekas score in the clinical outcome of acute cerebral infarction with leukoaraiosis(ACIL)patients after 90 days.Methods A total of 96 acute cerebral infarction patients with an National Institutes of Health Stroke Scale(NIHSS)score of 8 who were admitted to the Suzhou Hospital Affiliated to Anhui Medical University from August 2020 to October 2021 were selected as the research objects.Enzyme-linked immunosorbent assay was used to detect serum VCAM-1 levels,and Fazekas score was determined for all patients according to brain magnetic resonance.Based on the modified Rankin scale(mRS),the prognosis of patients at 90 days was evaluated.mRS≤2 was regarded as good prognosis(70 cases),and mRS≥3 was regarded as poor prognosis(26 cases).The receiver operating characteristic(ROC)curve was used to analyse the value of serum VCAM-1 level combined with Fazekas score in evaluating the prognosis of ACIL patients.Results Compared with the good-prognosis group,the age[(71.23±3.66)years vs.(64.57±5.24)years],serum VCAM-1 level[2.66(2.48,2.78)ng/mL vs.2.10(1.40,2.23)ng/mL],and Fazekas score[4(4,5)points vs.3(2,3)points]of the poor-prognosis group were significantly higher than those in the good-prognosis group(all P<0.05).Multivariate logistic-regression analysis showed that age,VCAM-1 level and Fazekas score were independent risk factors for poor prognosis.ROC curve analysis results revealed that the sensitivity and specificity of poor prognosis assessment were 92.31%and 94.29%,respectively.Conclusion Serum VCAM-1 combined with Fazekas score has a high predictive value for the 90-day outcome of acute cerebral infarction patients.
作者
刘时华
张超
陈雷
汪群峰
钟平
LIU Shi-hua;ZHANG Chao;CHEN Lei;WANG Qun-feng;ZHONG Ping(Department of Neurology,Suzhou Hospital of Anhui Medical University,Suzhou,Anhui 234000,China)
出处
《中华全科医学》
2022年第9期1481-1483,1564,共4页
Chinese Journal of General Practice
基金
安徽省高校自然科学研究项目(KJ2020A0193)
安徽医科大学校级科研项目(2019xkj240)。
