脑梗死患者血清学指标与病情的相关性及预后影响因素分析

Correlation between serological indexes with disease severity in patients with cerebral infarction and analysis of prognostic influencing factors

目的探讨脑梗死患者血清D-二聚体(DD)、高敏C反应蛋白(hs-CRP)和白细胞介素-6(IL-6)水平与梗死严重程度和预后的关系,同时对影响患者预后的因素进行分析,筛选影响预后的独立危险因素。方法选取2014年1月到2015年6月该院收治的脑梗死患者81例为研究对象,所有患者入院后均接受脑梗死常规治疗。入院时,采用NIHSS量表评估脑梗死梗死严重程度,检测血清DD、hs-CRP和IL-6水平。出院后随访12个月,采用MRS量表评估预后。分析DD、hs-CRP和IL-6水平与梗死严重程度和预后的相关性。采用单因素分析和多元Logistic回归分析对预后影响因素进行分析。结果入院时,重度组DD、hsCRP和IL-6水平显著高于中度组(q分别为5.736、7.772、4.757,P<0.05)和轻度组(q分别为11.094、16.920、12.255,P<0.05),而中度组又明显高于轻度组(q分别为5.783、9.870、8.049,P<0.05)。Pearson分析显示,DD、hs-CRP和IL-6水平与脑梗死严重程度呈正相关性(r分别为0.603、0.457、0.394,P<0.05)。随访12个月,预后良好组DD、hs-CRP和IL-6水平显著低于预后不良组(t分别为4.775、3.101、2.910,P<0.05)。Pearson分析显示,DD、hs-CRP和IL-6水平与预后不良呈正相关性(r分别为0.584、0.513、0.432,P<0.05)。多元Logistic回归分析显示,梗死体积、NIHSS评分、DD、hs-CRP和IL-6是脑梗死预后不良的独立危险因素(P<0.05)。结论梗死体积、NIHSS评分、DD、hs-CRP和IL-6是脑梗死预后不良的独立危险因素,可为脑梗死患者的预后判断提供一定的参考。

Objective To investigate the relationship between serum levels of D-dimer(DD),hs-CRP and IL-6with the infarction severity and prognosis in the patients with cerebral infarction(CI),and to analyze the influencing factors of prognosis for screening the independent risk factors affecting prognosis.Methods Eighty-one patients with CI in our hospital from January 2014 to June2015were selected as research subjects.All patients were treated with the CI routine treatment after admission.On admission,the CI severity was assessed by NIHSS,the serum levels of DD,hs-CRP and IL-6were detected.After discharge,following up lasted for12 months,the prognosis was assessed by MRS scale.The correlation between DD,hs-CRP and IL-6with the infarction severity and prognosis was analyzed.The prognostic influencing factors were analyzed by adopting the univariate analysis and multivariate Logistic regression analysis.Results On admission,the levels of DD,hs-CRP and IL-6in the severe group were significantly higher than those in the moderate group(q=5.736,7.772,4.757,P<0.05)and the mild group(q=11.094,16.920,12.255,P<0.05),while the moderate group was significantly higher than the mild group(q=5.783,9.870,8.049,P<0.05).Pearson′s analysis showed that the levels of DD,hs-CRP and IL-6were positively correlated with the CI severity(r=0.603,0.457,0.394,P<0.05).After following up for 12 months,the levels of DD,hs-CRP and IL-6in the good prognosis group were significantly lower than those in the poor prognosis group(t=4.775,3.101,2.910,P<0.05).Pearson′s analysis showed that DD,hs-CRP and IL-6levels were positively correlated with poor prognosis(r=0.584,0.513,0.432,P<0.05).Multiple Logistic regression analysis showed that infarct volume,NIHSS score,DD,hs-CRP and IL-6were the independent risk factors for poor prognosis in the patients with CI(P<0.05).Conclusion The infarct volume,NIHSS score,DD,hs-CRP and IL-6are the independent risk factors for poor prognosis in the patients with CI,which provide a certain reference for judging the prognosis in CI patients.