脑脊液中游离脂肪酸含量对脑梗死急性期患者的预后价值

Prognostic value of free fatty acid content in cerebrospinal fluid in patients with acute cerebral infarction

目的探讨脑脊液(CSF)中游离脂肪酸(FFA)水平对急性脑梗死(ACI)患者的预后作用。方法选取2012年1月至2014年12月本院收治的275例ACI患者为研究对象,在入院时采用美国国立卫生研究院卒中量表(NIHSS)对患者卒中程度进行评分,同时检测患者CSF中FFA水平。90d后对患者采用改良Rankin量表进行预后评价,然后采用Logistic回归分析FFA对ACI患者中的预后价值。结果 CSF中FFA的水平与NIHSS评分及ACI病灶体积呈明显的正相关。198例预后良好的患者CSF中FFA的水平明显低于77例预后不良的患者(P<0.05),而232例生存患者CSF中FFA的水平明显低于43例死亡患者(P<0.05),差异均有统计学意义。多变量分析结果显示,CSF中FFA水平超过0.301mmol·L-1时,患者预后不良的风险增加(OR=5.28,P<0.0001)。结论 ACI患者入院早期CSF中FFA水平可以作为患者短期预后的独立指标之一。

Objective To evaluated the prognostic value of cerebrospinal fluid （ CSF ） free fatty acid （ FFA ） levels in patients confirmed with acute cerebral infarction （ ACI ） . Method Two hundred and seventy five cases of ACI patients were selected as study subjects in our hospital from January 2012 to December 2014. The National Institutes of Health Stroke Scale （ NIHSS ） score on admission was applied to assess specific severity degree of stroke, and the CSF levels of FFA was measured using an enzyme cycling method. The prognostic outcomes of those cerebral infarction were evaluated by the modified Rankin scale scores at 90-days. The prognostic value of FFA was analyzed by Logistic regression analysis. Results NIHSS score and severity of ACI results suggested a positive relationship between levels of CSF FFA levels. The CSF levels of FFA in one hundred and ninety-eight patients with favorable outcome were significantly lower than seventy seven patients with unfavorable outcomes （ P〈0.05 ） . The CSF levels of FFA in A two hundred and thirty-two cases of survival patients were significantly lower than forty-three cases dead patients（ P〈0.05 ）. Multivariate analysis results showed that there was an increased risk of unfavorable outcome associated with CSF FFA levels I〉 0.301mmol · L-1 （ OR=5.28,P〈0.0001 ） . Conclusion The CSF level of FFA at admission was suggested to be an independent short-term prognostic marker in patient with ACI.