摘要
目的探讨血清同型半胱氨酸(Hcy)水平与接受静脉溶栓治疗的急性脑梗死患者短期预后的相关性。方法选取2018年1月—2020年1月新乡市中心医院接受静脉重组人组织型纤溶酶原激活物溶栓治疗的脑梗死患者172例。收集所有患者的临床资料和实验室检测结果。采用改良Rankin量表(mRS)评分评估急性脑梗死患者发病3个月时的功能恢复情况。采用受试者工作特征(ROC)曲线评估各项指标判断患者功能预后的最佳临界值。采用二元Logistic回归分析评估发病3个月时急性脑梗死患者功能预后的危险因素。结果根据ROC曲线得出的血清Hcy判断急性脑梗死患者发病3个月时功能预后的最佳临界值(21.1μmol/L)分为低Hcy(≤21.1μmol/L)组(127例)和高Hcy(>21.1μmol/L)组(45例)。低Hcy组年龄、溶栓前美国国立卫生研究院卒中量表(NIHSS)评分和发病3个月时mRS评分均显著低于高Hcy组(P<0.05)。2个组之间性别、入院至溶栓开始的时间、发病至溶栓时间、血糖、D-二聚体、国际标准化比值(INR)、血红蛋白、既往史和脑梗死体积、部位差异均无统计学意义(P>0.05)。多因素二元Logistic回归分析结果显示,年龄>75岁、溶栓前NIHSS评分>7分和Hcy>21.1μmol/L是急性脑梗死患者发病3个月时功能预后不良的独立危险因素[比值比(OR)值分别为3.12、4.64和2.04,95%可信区间(CI)分别为1.54~8.21、1.75~10.02和1.09~7.43]。结论血清Hcy水平升高与接受静脉溶栓治疗的急性脑梗死患者发病3个月时功能预后不良密切相关。
Objective To investigate the correlation between serum homocysteine(Hcy)level and short-term prognosis of acute cerebral infarction patients receiving intravenous thrombolysis.Methods Totally,172 patients with cerebral infarction who received intravenous recombinant human tissue-type fibrinogen activator thrombolytic therapy in Xinxiang Central Hospital from January 2018 to January 2020 were enrolled.The clinical data and laboratory determination results of all the patients were collected.Functional recovery of patients with acute cerebral infarction at 3 months of onset was assessed using the modified Rankin scale(mRS)score.Receiver operating characteristic(ROC)curve was used to determine the optimal cut-off value for patients'functional prognosis.Risk factors for functional prognosis of patients with acute cerebral infarction at 3 months of onset were assessed using binary Logistic regression analysis.Results The patients was classified into low Hcy(≤21.1μmol/L)group(127 cases)and high Hcy(>21.1μmol/L)group(45 cases)according to the optimal cut-off value of Hcy(21.1μmol/L)from the ROC curve.The age,pre-thrombolysis the National Institute of Health Stroke Scale(NIHSS)score and mRS score at 3 months of onset were lower in low Hcy group than those in high Hcy group(P<0.05).The differences in sex,time from admission to thrombolysis,time from onset to thrombolysis,blood glucose,D-dimer,international normalized ratio(INR),hemoglobin,past history and infarct volume and location between the 2 groups had no statistical significance(P>0.05).The results of multivariate binary Logistic regression analysis showed that age>75,pre-thrombolysis NIHSS score>7 and Hcy>21.1μmol/L were independent risk factors for poor functional prognosis in patients with acute cerebral infarction at 3 months of onset[odds ratios(OR)were 3.12,4.64 and 2.04,95%confidence intervals(CI)were 1.54-8.21,1.75-10.02 and 1.09-7.43].Conclusions Elevated serum Hcy levels are correlated with poor functional prognosis at 3 months of onset in patients wi
作者
畅慧君
张敏
张其相
CHANG Huijun;ZHANG Min;ZHANG Qixiang(Department of Neurology,Xinxiang Central Hospital,Xinxiang 453000,Henan,China;Department Clinical Pharmacology,Xinxiang Central Hospital,Xinxiang 453000,Henan,China)
出处
《检验医学》
CAS
2023年第11期1057-1061,共5页
Laboratory Medicine
关键词
同型半胱氨酸
急性脑梗死
静脉溶栓治疗
Homocysteine
Acute cerebral infarction
Intravenous thrombolysis
