摘要
目的:探讨老年急性脑梗死(ACI)患者血清同型半胱氨酸(Hcy)、缺血修饰蛋白(IMA)水平与神经功能缺损程度和预后的关系。方法:选取207例老年ACI患者为研究对象,根据美国国立卫生院卒中量表(NIHSS)评分分为神经缺损轻度组(NIHSS<4分,n=59)、中度组(NIHSS=4~15分,n=96)及重度组(NIHSS>15分,n=52);根据患者治疗1个月后改良Rankin量表(mRs)评分分为预后良好组(mRs≤2分,n=160)及预后不良组(mRs>2分,n=47)。比较不同程度神经缺损及不同预后患者血清Hcy、IMA水平,分析其与神经缺损程度的相关性及对ACI患者预后不良的预测诊断价值。结果:不同程度神经缺损组患者血清Hcy、IMA水平比较,差异有统计学意义(P<0.05),且重度组>中度组>轻度组。预后良好组患者血清Hcy、IMA水平低于预后不良组(P<0.05)。相关性分析显示,血清Hcy、IMA水平与老年ACI神经功能缺损程度呈正相关关系(r=0.326、0.513,P<0.05)。ROC曲线分析显示,血清Hcy(AUC=0.711)及IMA(AUC=0.829)对老年ACI患者预后不良均有良好的预测诊断价值,且两者联合检测的诊断效能更佳(AUC=0.861)。结论:血清Hcy、IMA水平不仅能反应老年ACI患者的神经缺损程度,还有助于评估近期预后状况。
Objective:To explore the relationship between the levels of serum homocysteine(Hcy)and ischemia modified albumin(IMA)and the degree of neurological impairment and prognosis in elderly patients with acute cerebral infarction.Methods:207 elderly patients with ACI were selected as the research subjects.According to the National Institutes of Health Stroke Scale(NIHSS),the patients were divided into mild neurological deficit group(NIHSS<4 points,n=59),moderate group(NIHSS of 4~15 points,n=96)and severe group(NIHSS>15 points,n=52).After 1 month of treatment,the patients were classified as good prognosis group(mRs≤2 points,n=160)and poor prognosis group(mRs>2 points,n=47)according to the modified Rankin scale(mRs).The levels of serum Hcy and IMA in patients with different degree of nerve defect and different prognosis were compared,and the correlation between them and the degree of nerve defect was analyzed,as well as the predictive diagnostic value of poor prognosis in patients with ACI.Results:The difference of serum Hcy and IMA levels in patients with different degree of nerve defect was statistically significant(P<0.05),and from high to low,there were severe group,moderate group and mild group.The levels of serum Hcy and IMA of patients in good prognosis group at enrollment were lower than those in poor prognosis group(P<0.05).Spearman correlation coefficient analysis showed that serum Hcy and IMA levels were positively correlated with degree of neurological deficit(r=0.326,0.513,all P<0.05).ROC curve displayed that serum Hcy(AUC=0.711)and IMA(AUC=0.829)had a good predictive value on the poor prognosis of elderly patients with ACI,and the combined detection of the two showed better diagnostic efficiency(AUC=0.861).Conclusion:Serum Hcy and IMA levels can not only reflect the degree of neurological deficit in elderly patients with ACI,but also help assess the short-term prognosis status.
作者
范晓雪
王超
于琦莉
于洪
FAN Xiao-xue;WANG Chao;YU Qi-li;YU Hong(Departments of Neurology,the First Hospital of Qiqihar,Qiqihar Hospital Affiliated to Southern Medical University,Qiqihar 161000,Heilongjiang,China;Department of Education Administration,the First Hospital of Qiqihar,Qiqihar Hospital Affiliated to Southern Medical University,Qiqihar 161000,Heilongjiang,China)
出处
《川北医学院学报》
CAS
2023年第4期470-473,共4页
Journal of North Sichuan Medical College
基金
黑龙江省齐齐哈尔市科学技术局科研项目(2021第215号)。
