摘要
目的探讨应激性血糖升高比值(SHR)联合A2DS2(年龄、心房纤颤、吞咽困难、性别、卒中严重度)评分在卒中相关性肺炎(SAP)病情及预后评估中的应用价值。方法回顾性分析于2022年10月至2023年10月上海市第六人民医院收治的118例SAP患者的临床资料,依据美国国立卫生研究院卒中量表(NIHSS)评价病情结果分为轻度组[NIHSS评分≤5分,n=36]、中度组(NIHSS评分5~15分,n=52)、重度组(NIHSS评分>15分,n=30)。依据3个月临床结局分为死亡组(n=39)和存活组(n=79)。分别比较不同病情严重程度组、不同临床结局组基线资料、SHR、A2DS2评分;采用Spearman相关性检验分别分析病情严重程度、临床结局与SHR和A2DS2评分的关系;采用受试者操作特征(ROC)曲线下面积(AUC)检验SHR联合A2DS2评分预测SAP患者病情严重程度和临床结局的效能。结果轻、中、重度组基线资料比较,差异均无统计学意义(P>0.05)。存活组与死亡组基线资料比较,差异均无统计学意义(P>0.05)。重度组SHR、A2DS2评分分别为1.55±0.31、(6.08±2.01)分,均高于轻度组[1.03±0.25、(2.44±0.73)分]、中度组[1.32±0.27、(4.45±1.12)分],差异均有统计学意义(P<0.05)。死亡组SAP患者SHR、A2DS2评分分别为1.68±0.50、(6.32±2.13)分,均高于存活组[1.37±0.32、(4.72±1.41)分],差异均有统计学意义(P<0.05)。Spearman相关性检验分析结果显示,SHR和A2DS2评分与SAP患者病情严重程度呈正相关(r=0.457、0.486,P<0.05),且SHR和A2DS2评分与SAP患者临床不良结局呈正相关(r=0.403、0.437,P<0.05);根据ROC曲线下AUC预测价值,SHR联合A2DS2评分联合预测SAP患者病情严重程度的AUC为0.933(95%CI:0.876~0.991)(P<0.05),且SHR联合A2DS2评分联合预测SAP患者临床结局的AUC为0.839(95%CI:0.756~0.922),具有较好预测价值(P<0.05)。结论SHR、A2DS2评分与SAP患者病情进展及预后具有重要相关性,两者联合评估具备较高的预测SAP患者病情及预后的效能,可
Objective To investigate the application value of stress hyperglycemia ratio(SHR)combined with A2DS2(age,atrial fibrillation,dysphagia,gender,stroke severity)score on the evaluation of disease condition and prognosis of stroke-associated pneumonia(SAP).Methods The clinical data of 118 patients with SAP in the hospital from October 2022 to October 2023 were retrospectively analyzed.According to the results of National Institutes of Health stroke scale(NIHSS),the patients were divided into the mild group[NIHSS score≤5 points,n=36],the moderate group(NIHSS score of 5-15 points,n=52)and the severe group(NIHSS score>15 points,n=30).By means of the three-month clinical outcomes,the patients were classified into the death group(n=39)and the survival group(n=79).The baseline data,SHR and A2DS2 score were compared among different severity groups and different clinical outcome groups.Spearman correlation test was used to analyze the relationship between disease severity,clinical outcomes and SHR and A2DS2 score.The area under the receiver operating characteristic(ROC)curve(AUC)was used to test the efficiency of SHR combined with A2DS2 score on predicting the disease severity and clinical outcomes of SAP patients.Results There were no statistically significant differences in baseline data among the mild,moderate and severe groups(P>0.05).There were no statistically significant differences in baseline data between the survival and death groups(P>0.05).The scores of SHR and A2DS2 in the severe group were 1.55±0.31 and(6.08±2.01)points,respectively,which were higher than those in the mild group[1.03±0.25,(2.44±0.73)points]and the moderate group[1.32±0.27,(4.45±1.12)points],and the differences were statistically significant(P<0.05).The SHR and A2 DS2 scores of SAP patients in the death group were 1.68±0.50 and(6.32±2.13)points,respectively,which were higher than those in the survival group[1.37±0.32 and(4.72±1.41)points],and the differences were statistically significant(P<0.05).Spearman correlation test showed that
作者
徐敏
王英钜
柏晓林
黄立刚
XU Min;WANG Ying-ju;BAI Xiao-lin(Department of Emergency,Shanghai Sixth People's Hospital,Shanghai 200233,China)
出处
《临床和实验医学杂志》
2024年第22期2361-2365,共5页
Journal of Clinical and Experimental Medicine
基金
上海市科学技术委员会科研计划项目(编号:19401972805)。
