超敏肌钙蛋白I对急性缺血性卒中患者预后的影响及预测价值研究

目的 探究超敏肌钙蛋白I (hs-TnI)对急性缺血性卒中患者预后的影响及预测价值。 方法 回顾性分析2018年1—3月在诸暨市人民医院神经内科就诊的100例急性缺血性卒中患者临床资料,依据患者在90 d随访时Rankin量表(mRS)评分将其分为预后良好组(mRS 0~2分)和预后不良组(mRS 3~6分)。比较所有患者的临床资料和治疗前实验室检查指标,分析hs-TnI水平与90 d预后的关系。采用受试者工作曲线(ROC)分析hs-TnI对急性缺血性卒中患者预后的预测价值。 结果 预后不良组患者年龄、女性比例、美国国立卫生研究院卒中量表(NIHSS)评分、曾患有卒中比例、收缩压、住院时间明显高于预后良好组(均P<0.05);预后不良组病史及吸烟史比例、舒张压、心率与预后良好组比较差异均无统计学意义(均P>0.05);预后不良组空腹血糖、低密度脂蛋白、血肌酐水平与预后良好组比较差异无统计学意义(均P>0.05),预后不良组白细胞计数水平、hs-TnI水平明显高于预后良好组(均P<0.05),血红蛋白、血细胞比容水平明显低于预后良好组(均P<0.05);女性、年龄、既往卒中病史、入院时NIHSS评分、hs-TnI为预后不良的独立危险因素,血红蛋白为预后良好的保护性因素(均P<0.05);hs-TnI的AUC值为0.818。 结论 hs-TnI升高是急性缺血性卒中患者预后的独立危险因素。 

Effect of hs-TnI on the prognosis of patients with acute ischemic stroke and its predictive value

Objective To explore the effect of hypersensitive troponin I(hs-TnI) on the prognosis of patients with acute ischemic stroke and its predictive value. Methods A total of 100 patients with acute ischemic stroke who were admitted to the Department of Neurology, the People's Hospital of Zhuji from January to March 2018 were included as the objects of study retrospectively. According to the mRS score of 90 days follow-up, the patients were divided into good prognosis(mRS 0-2) group and poor prognosis(mRS 3-6). Clinical data and laboratory examination indicators of all patients before treatment were compared. The relationship between hs-TnI level and 90-day prognosis was analyzed by binary logistic regression. The predictive value of hs-TnI in the prognosis of patients with acute ischemic stroke was analyzed by receiver operating curve(ROC). Results The age, female ratio, NIHSS score, proportion of disease history, systolic blood pressure and hospitalization time in poor prognosis group were significantly higher than those in good prognosis group(all P<0.05). There were no significant differences in proportion of disease history, smoking history, diastolic blood pressure, heart rate, and the levels of fasting blood glucose, low density lipoprotein and serum creatinine between two group(all P>0.05). The leucocyte count and hs-TnI in the poor prognosis group was significantly higher than that in the good prognosis group(all P<0.05). The levels of hemoglobin and hematocrit were significantly lower than those in the good prognosis group(all P<0.05). The results of binary logistic regression analysis showed that women, age, history of stroke, NIHSS score at admission and hs-TnI were independent risk factors for poor prognosis, while hemoglobin was a protective factor for good prognosis(all P<0.05). The AUC value of hs-TnI was 0.818. Conclusion The increase of hs-TnI is an independent risk factor for patients with acute ischemic stroke.