摘要
目的探讨全身炎症反应指数(systemic inflammation response index,SIRI)与急性缺血性脑卒中患者早期神经功能恶化(early neurological deterioration,END)及发病后3个月预后结局的关系。方法收集2020年4月—10月四川大学华西医院和德阳市人民医院诊治的急性缺血性脑卒中患者,登记患者临床资料并随访3个月。根据患者的不良结局分为END组和非END组。采用多因素logistic回归分析探究SIRI、END及发病后3个月时预后的关系,并绘制接受者操作特征曲线评价相关因素预测发生END及发病后3个月预后不良的价值。结果共纳入患者242例。其中,发生END 47例(19.4%)。两组在入院美国国立卫生研究卒中量表(National Institutes of Health stroke Scale,NIHSS)评分、高血压、肌酐、尿素氮、血中性粒细胞计数、血淋巴细胞计数、中性粒细胞计数/淋巴细胞计数比(neutrophil count/lymphocyte count ratio,NLR)、淋巴细胞计数/单核细胞计数比、血小板计数/淋巴细胞计数比、除脑水肿外的其他并发症、SIRI比较,差异均有统计学意义(P<0.05)。logistic回归分析结果显示,入院NIHSS评分、高血压、SIRI及NLR是发生END的独立危险因素(P<0.05)。SIRI较NLR对END的发生具有更佳的预测价值(P<0.05)。与非END组比较,END组患者的发病后3个月的预后结局更差[44.7%(21/47)vs.17.4%(34/195),P<0.05]。入院时NIHSS评分对急性缺血性脑卒中患者发病后3个月时预后不良具有一定的预测价值。结论SIRI是急性缺血性脑卒中患者发生END的独立危险因素,与发病后3个月结局无独立相关性。
Objective To investigate the relationship between systemic inflammation response index(SIRI)and early neurological deterioration(END)and 3-month prognosis in patients with acute ischemic stroke.Methods Patients with acute ischemic stroke treated at West China Hospital of Sichuan University and Deyang People’s Hospital between April 2020 and October 2020 were collected.Clinical data were collected using a unified case form and outcomes were followed up for 3 months.According to the poor prognosis,the patients were divided into END group and non-END group.The multivariate logistic regression analysis was used to explore the relationship of SIRI,END and 3-month prognosis.We drew receiver operating characteristic curve to evaluate the value of related factors in predicting the occurrence of END and poor prognosis after 3 months.Results A total of 242 patients were included,of which 47(19.42%)were in the END group.There were statistically significant differences between the two groups in National Institutes of Health stroke Scale(NIHSS)score on admission,hypertension,creatinine,urea nitrogen,neutrophils count,lymphocyte count,neutrophil count/lymphocyte count ratio(NLR),lymphocyte count/monocyte count ratio,platelet count/lymphocyte count ratio,complications(besides cerebral edema)and SIRI(P<0.05).Logistic regression analysis showed that NIHSS score on admission,hypertension,SIRI and NLR were independent risk factors for END(P<0.05).SIRI had better predictive value for the occurrence of END than NLR(P<0.05).Compared with the non-END group,the patients in the END group had worse prognosis at 3-month[44.7%(21/47)vs.17.4%(34/195),P<0.05].NIHSS score on admission had predictive value for clinical prognosis of acute ischemic stroke patients at 3-month.Conclusion SIRI is an independent risk factor for END in patients with acute ischemic stroke,and there is no independent correlation with the 3-month prognosis.
作者
何妮
黄攀
刘梦
孟冰
郝子龙
HE Ni;HUANG Pan;LIU Meng;MENG Bing;HAO Zilong(Department of Neurology,West China Hospital,Sichuan University,Chengdu,Sichuan 610041,P.R.China;Department of Neurology,Deyang People’s Hospital,Deyang,Sichuan 618000,P.R.China)
出处
《华西医学》
CAS
2024年第4期580-587,共8页
West China Medical Journal
基金
科技创新2030-“新一代人工智能”重大项目(2022ZD0118003)
四川大学华西医院学科发展1·3·5工程项目(ZYGD18009)
四川大学华西医院临床研究孵化项目(2021HXFH043)。
