全球免疫营养炎症指数对老年首发急性轻型缺血性卒中90 d预后不良的预测价值

doi:10.3969/j.issn.1003-9198.2025.12.010

摘要/Abstract

摘要： 目的探讨全球免疫营养炎症指数(global immune-nutrition-inflammation index, GINI)对老年首发急性轻型缺血性卒中(acute minor ischemic stroke,AMIS)病人90 d预后的预测价值。方法收集2021年7月至2023年7月江苏大学附属医院卒中中心收治的老年首发AMIS病人371例。根据90 d的改良Rankin量表评分(modified Rankin Scale score,mRS)将病人分为预后良好组(mRS≤2分,n=337)和预后不良组(mRS>2分,n=34),对2组间的一般临床资料进行比较分析,采用多因素logistic回归分析预后不良的独立相关因素,绘制ROC曲线评估GINI对老年首发AMIS病人90 d预后不良的预测价值。结果与预后良好组相比,预后不良组富集红细胞和单核细胞明显,伴随更显著的炎症反应(C反应蛋白和中性粒细胞偏高),更严重的神经功能受损及更大的梗死体积,同时住院时间明显延长(P<0.05)。多因素logistic回归分析显示,GINI(OR=1.576,95%CI:1.219～2.072)与老年首发AMIS病人90 d预后不良独立相关(P<0.05)。ROC曲线分析显示,GINI预测老年首发AMIS病人90 d预后不良的AUC为0.759(95%CI:0.692～0.827,P<0.05),最佳临界值为1.689。结论 GINI与老年首发AMIS病人90 d预后不良独立相关,可成为其潜在的预测因子。

关键词: 全球免疫营养炎症指数, 老年人, 缺血性卒中, 预后, 炎症

Abstract: Objective To explore the predictive value of the global immune-nutrition-inflammation index (GINI) for 90-day prognosis of elderly patients with first-onset acute minor ischemic stroke (AMIS). Methods A total of 371 elderly patients diagnosed with first-onset AMIS admitted to the Stroke Center of the Affiliated Hospital of Jiangsu University from July 2021 to July 2023 were included. Based on the modified Rankin Scale score (mRS) at 90 days, patients were categorized into a favorable prognosis group (mRS ≤ 2, n=337) and a poor prognosis group (mRS > 2, n=34). Comparative analysis of general clinical data was performed between the two groups. Multivariate logistic regression analysis was employed to identify independent risk factors associated with poor prognosis. Receiver operating characteristic (ROC) curve analysis was utilized to assess the predictive value of GINI for 90-day poor prognosis. Results In comparison to the favorable prognosis group, the poor prognosis group exhibited higher enrichments of red blood cells and monocytes, alongside a more pronounced inflammatory response characterized by elevated levels of C-reactive protein and neutrophils. This group also experienced more severe neurological impairment, larger infarct volume, and extended hospital stay (P<0.05). Multivariate logistic regression analysis revealed that GINI was an independent predictor of prognosis at 90-day in elderly patients with AMIS (OR=1.576, 95%CI: 1.219－2.072, P<0.05). ROC curve analysis demonstrated that the area under the curve of GINI for predicting poor prognosis in the elderly first-onset AMIS patients was 0.759 (95%CI: 0.692－0.827, P<0.05) with an optimal cutoff value of 1.689. Conclusions GINI is independently associated with poor prognosis at 90-day in elderly patients with first-onset AMIS, and may serve as a potential predictive factor.

Key words: global immune-nutrition-inflammation index, aged, ischemic stroke, prognosis, inflammation

中图分类号:

R 743.3

武文琦, 杨溢, 于明. 全球免疫营养炎症指数对老年首发急性轻型缺血性卒中90 d预后不良的预测价值[J]. 实用老年医学, 2025, 39(12): 1238-1242.

WU Wenqi, YANG Yi, YU Ming. The predictive value of the global immune-nutrition-inflammation index for 90-day prognosis in elderly patients with first-onset acute minor ischemic stroke[J]. Practical Geriatrics, 2025, 39(12): 1238-1242.

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