进展性脑梗死患者红细胞分布宽度的动态变化及预后风险评估

目的观察进展性缺血性脑卒中(PIS)患者的红细胞分布宽度(RDW)、氧化低密度脂蛋白(ox-LDL)与超敏C反应蛋白(hs-CRP)水平的动态变化,探讨其对PIS病情严重程度及评估预后的价值。方法选择急性脑梗死患者100例,分为进展组(PIS组)50例、非进展组(非PIS组)50例,分别测定两组患者发病24h、2d、3d、7d、14d RDW、ox-LDL与hs-CRP水平及SSS评分,并随访患者3月时改良Rankin量表(m RS)评分,采用Cox比例风险回归分析进展性缺血性脑卒中预后。结果治PIS组RDW、ox-LDL与hs-CRP水平在发病24h、第2、3、7、14d明显高于非PIS组(P0.01);Pearson相关分析显示,RDW与ox-LDL、hs-CRP及SSS评分水平呈显著正相关(P0.01)。Cox回归分析显示RDW、ox-LDL、hs-CRP是患者预后不良的支持因素(P0.01)。结论 RDW联合ox-LDL与hs-CRP可提高对PIS病情严重程度的判断能力,同时有助于评估患者预后。

Dynamic changes of red cell distribution width in patients with cerebral infarction and risk assessment of prognosis

Objective To observe the clinical significance of detection of RDW, ox-LDL and hs-CRP in patients with progressive ischemic stroke, and investigate it spotential for evaluating the severity and prognosis of progressive ischemic stroke.Method 100 patients with acute cerebral infarction were divided into progressive ischemic stroke (PIS) group of 50 cases and non-progressive ischemic stroke (NPIS) of 50 cases. RDW, ox-LDL and hs-CRP levels were determined at 24h, 2, 3, 7, 14 days in two groups. Follow-up of patients with the Modified Rankin Scale (MRS) score in march, adoptingCox proportional hazards regression analysis outcome of progressive ischemic stroke.Results The levels of RDW, ox-LDL and hs-CRP in the PIS group at 24h, 2d, 3d, 7d and 14d was higher than that of NPIS group (P<0.01). Pearson analysis showed that the levels of RDW were correlated with those of ox-LDL, hs-CRP and SSS score (P<0.01).Cox regression analysis showed that RDW, ox-LDL and hs-CRP were the predictors for the outcome in patients with progressive ischemic stroke (P<0.01).Conclusion RDW combined ox-LDL and hs-CRP may enhace the ability to judge the severity of patients with progressive ischemic stroke, and help to evaluate patients prognosis.