实用老年医学

实用老年医学 ›› 2024, Vol. 38 ›› Issue (6): 598-602.doi: 10.3969/j.issn.1003-9198.2024.06.013

• 临床研究 • 上一篇    下一篇

低灌注强度比值联合系统免疫炎症指数对老年缺血性卒中病人溶栓后早期神经功能恶化的预测价值

游嘉翔, 李晓溪, 夏峻, 李浩鹏, 王军   

  1. 210008 江苏省南京市,徐州医科大学南京鼓楼临床学院(游嘉翔,夏峻,李浩鹏,王军);
    210008 江苏省南京市,南京大学医学院附属鼓楼医院急诊科(李晓溪)
  • 收稿日期:2023-12-25 出版日期:2024-06-20 发布日期:2024-06-19
  • 通讯作者: 王军,Email:wjgaogou@aliyun.com

Predictive value of hypoperfusion intensity ratio combined with systemic immune-inflammation index for early neurological deterioration after thrombolysis in elderly patients with acute ischemic stroke

YOU Jiaxiang, LI Xiaoxi, XIA Jun, LI Haopeng, WANG Jun   

  1. Xuzhou Medical University Nanjing Clinical Medical College,Nanjing 210008,China(YOU Jiaxiang, XIA Jun, LI Haopeng, WANG Jun);
    Department of Emergency, Nanjing Drum Tower Hospital, Affiliated Hospital of Nanjing University Medical School, Nanjing 210008,China(LI Xiaoxi)
  • Received:2023-12-25 Online:2024-06-20 Published:2024-06-19
  • Contact: WANG Jun, Email:wjgaogou@aliyun.com

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摘要： 目的 探讨低灌注强度比值(hypoperfusion intensity ratio,HIR)联合系统免疫炎症指数(systemic-immune inflammation index, SII)预测老年急性缺血性卒中(acute ischemic stroke, AIS)病人发生神经恶化的价值。方法 回顾性分析2020年1月至2022年12月南京鼓楼医院急诊科收治的 185例老年AIS病人为研究对象,根据是否发生早期神经功能恶化(early neurological deterioration, END)分为END组与非END组。统计分析2组基线资料,并采用Logistic回归分析END发生的危险因素。采用ROC曲线分析HIR、SII对老年AIS病人END的预测价值。结果 185例老年AIS病人中有 41例病人出现END,其发生率为 22.2%;END组的HIR、SII、入院时NIHSS评分、血糖均高于非END组,差异均有统计学意义(P＜0.05); Logistic回归分析结果显示,入院时较高HIR(OR=1.065,95%CI:1.038~1.092)、高SII(OR=1.001,95%CI:1.000~1.001)、高NIHSS评分(OR=1.063,95%CI:1.003~1.127)、高血糖(OR=1.186,95%CI:1.039~1.354)是老年AIS病人发生END的独立危险因素(P＜0.05);入院时各项指标预测老年AIS病人END发生的ROC曲线分析结果显示, HIR、SII、NIHSS评分、血糖、HIR联合SII的AUC分别为0.861、0.658、0.728、0. 665、0. 885,其中HIR联合SII的AUC高于单独预测。结论 HIR、SII是AIS病人发生END的重要影响因素,两者联合检测对END的预测价值更高。

关键词: 急性缺血性卒中, 早期神经功能恶化, 低灌注强度比值, 系统免疫炎症指数, 预测价值

Abstract: Objective To investigate the predictive value of hypoperfusion intensity ratio (HIR) combined with systemic immune-inflammation index (SII) for the occurrence of early neurological deterioration (END) in the elderly patients with acute ischemic stroke (AIS) after thrombolysis. Methods A total of 185 patients with AIS admitted to Department of Emergency of Nanjing Drum Tower Hospital from January 2020 to December 2022 were retrospectively enrolled in this study, and they were divided into END group and non-END group. The baseline data of the two groups were statistically analyzed. Logistic regression model was used to analyze the risk factors for the occurrence of END. The predictive value of HIR and SII for END in the elderly patients with AIS was analyzed by using receiver operating characteristics (ROC) curve. Results There were 41 patients presenting with END, with an incidence rate of 22.2%. The levels of HIR and SII, National Institutes of Health Stroke Scale (NIHSS) score at admission and blood glucose in END group were significantly higher than those in non-END group (P<0.05); Logistic regression analysis showed that higher HIR (OR=1.065, 95% CI: 1.038-1.092), higher SII (OR=1.001, 95% CI: 1.000-1.001), higher NIHSS score at admission (OR=1.063, 95% CI: 1.003-1.127) and higher blood glucose (OR=1.186, 95% CI: 1.039-1.354) were the independent risk factors for the development of END in elderly AIS patients (P <0.05). The results of the ROC curve analysis of the indicators predicting the occurrence of END in the elderly patients with AIS showed that the AUC of HIR, SII, NIHSS score, blood glucose and HIR combined with SII at admission were 0.861, 0.658, 0.728, 0. 665, and 0. 885. Conclusions HIR and SII have important influences on the occurrence of END in the elderly patients with AIS, and the combined detection of HIR and SII has a higher predictive value for the occurrence of END.

Key words: acute ischemic stroke, hypoperfusion intensity ratio, early neurological deterioration, systemic-immune inflammation index, predictive value

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