摘要
目的 探讨血小板参数与凝血指标预测急性脑梗死(acute cerebral infarction, ACI)早期病情加重的应用价值。方法 选取郑州市第七人民医院2019年9月至2022年9月收治的ACI患者,按入院后72 h内是否发现病情加重进行分组,其中加重组(56例)、未加重组(128例),比较两组各项临床资料、血小板指标、凝血指标。采用logistic回归分析影响ACI病情加重的独立因素,采用ROC分析各项因素预测ACI病情加重的效能。结果 加重组入院时神经功能缺损评分(12.58±3.45)分、合并糖尿病比例(92.86%)、尿酸(525.83±38.58)μmol/L、同型半胱氨酸(24.73±4.48)μmol/L、C反应蛋白(23.57±4.69)mg/mL高于未加重组[(8.89±3.52)分、60.94%、(453.24±37.93)μmol/L、(18.63±3.58)μmol/L、(16.35±4.49)mg/mL](P<0.05);加重组PDW(18.26±4.28)%、PAC-1(9.88±2.44)%高于未加重组(15.69±4.52)%、(8.37±2.79)%,PLT(158.83±42.17)×10^(9)低于未加重组(195.62±36.83)×10^(9)(P<0.05);加重组Fg(4.59±2.47)g/L、TT(15.73±5.22)s、PT(14.57±3.54)s、APTT(36.93±9.82)s高于未加重组[(3.14±1.58)g/L、(13.58±3.58)s、(12.47±2.52)s、(32.57±6.39)s](P<0.05);logistic回归分析显示入院时NIHSS(OR=4.732)、合并糖尿病(OR=5.573)、SUA(OR=4.382)、Hcy(OR=5.492)、CRP(OR=4.062)、PLT(OR=0.486)、PDW(OR=5.693)、PAC-1(OR=4.629)、TT(OR=4.824)、PT(OR=4.982)、APTT(OR=5.393)、Fg(OR=5.794)均是ACI病情加重的独立影响因素(P<0.05);血小板参数单独及联合预测ACI病情加重的AUC值为0.728、0.725、0.652、0.766,凝血指标单独及联合预测ACI病情加重的AUC值为0.682、0.714、0.732、0.737、0.746,两组指标联合预测ACI病情加重的AUC值为0.952(P<0.05)。结论 血小板参数与凝血指标联合应用可准确预测ACI患者早期病情加重风险,为临床治疗提供参考。
Objective To investigate the application value of platelet parameters and coagulation index in predicting the early exacerbation of acute cerebral infarction(ACI).Methods ACI patients admitted from September 2019 to September 2022 were selected and divided into two groups according to whether their disease worsened within 72 hours after admission,including 56 cases with aggravation of condition(aggravation group)and 128 cases without aggravation of condition(no aggravation group).Clinical data,platelet indexes and coagulation indexes of the two groups were compared.logistic regression was used to analyze the independent factors affecting the exacerbation of ACI,and ROC was used to analyze the efficacy of each factor in predicting the exacerbation of ACI.Results Neurological deficit score(12.58±3.45)points,the ratio of diabetes mellitus(92.86%),uric acid(525.83±38.58)μmol/L,homocysteine(24.73±4.48)μmol/L and C-reactive protein(23.57±4.69)mg/mL were higher in aggravation group than those no aggravation group[(8.89±3.52)min,60.94%,(453.24±37.93)μmol/L,(18.63±3.58)μmol/L,(16.35±4.49)mg/mL](P<0.05).PDW(18.26±4.28)%and PAC-1(9.88±2.44)%were higher in aggravation group than those in no aggravation group(15.69±4.52)%,(8.37±2.79)%.The PLT(158.83±42.17)×10^(9) was lower in aggravation group than that in no aggravation group(195.62±36.83)×10^(9)(P<0.05).Fg(4.59±2.47)g/L,TT(15.73±5.22)s,PT(14.57±3.54)s,APTT(36.93±9.82)s were higher in aggravation group than those in no aggravation group(3.14±1.58)g/L,(13.58±3.58)s,(12.47±2.52)s,(32.57±6.39)s(P<0.05);logistic regression analysis showed that NIHSS(OR=4.732),diabetes mellitus(OR=5.573),SUA(OR=4.382),Hcy(OR=5.492),CRP(OR=4.062),PLT(OR=0.486),PDW(OR=5.693),P at admission AC-1(OR=4.629),TT(OR=4.824),PT(OR=4.982),APTT(OR=5.393),Fg(OR=5.794)were independent influencing factors of ACI exacerbation(P<0.05).The AUC values of platelet parameter alone and combined with ACI exacerbation were 0.728,0.725,0.652,0.766,and the AUC values of coagulation index alone
作者
周丽平
杨会杰
曾利敏
ZHOU Li-ping;YANG Hui-jie;ZENG Li-min(Department of Neurology,Zhengzhou the Seventh Peoples Hospital,Zhengzhou 450000,China)
出处
《医药论坛杂志》
2023年第16期44-47,51,共5页
Journal of Medical Forum
关键词
脑卒中
凝血
血小板
病情转归
生化指标
Cerebral apoplexy
Clotting
Platelets
Disease outcome
Biochemical index
