性激素水平在缺血性脑卒中急性期的变化及与进展性卒中的相关性

Changes of sex hormone levels in the acute phase of ischemic stroke and its correlation with progressive stroke

目的探讨性激素水平在缺血性脑卒中急性期的变化及与进展性卒中的相关性。方法选取海安市人民医院收治的103例急性缺血性脑卒中患者作为研究对象。根据是否发生进展性卒中,分为进展性卒中组(52例)和缺血性卒中组(51例),并选取同时期健康体检者50例作为对照组。对研究对象血清催乳素、孕酮、雌二醇的水平进行检测并比较差异。应用logistics回归模型分析影响急性缺血性脑卒中患者发生进展性卒中的危险因素。采用Pearson相关系数分析性激素水平与疾病严重程度的相关性。应用受试者工作(ROC)曲线评价性激素水平对进展性卒中的诊断价值。结果催乳素、孕酮水平在对照组、缺血性卒中中、进展性卒中组逐渐升高,差异均有统计学意义(P<0.05);雌二醇水平在缺血性卒中中、进展性卒中组中无明显差异(P>0.05),但均明显高于对照组(P<0.05);单因素和多因素回归分析显示:催乳素、孕酮为影响急性缺血性脑卒中患者发生进展性卒中的危险因素(P<0.05);催乳素、孕酮水平与患者疾病严重程度呈正相关(P<0.05),但雌二醇水平未显示出与疾病严重程度有明显相关性(P>0.05);ROC曲线分析发现,催乳素、孕酮的曲线下面积分别为0.905、0.937。结论孕酮、催乳素水平是影响急性缺血性脑卒中患者发生进展性卒中的危险因素,并与疾病严重程度呈正相关,可作为诊断进展性卒中的参考指标。

Objective To investigate the changes of sex hormone levels in the acute phase of ischemic stroke and its correlation with progressive stroke.Methods 103 patients with acute ischemic stroke admitted to our hospital were divided into progressive stroke group(52 cases)and ischemic stroke group(51 cases)depending on whether progressive stroke occurred.At the same time,50 healthy checkups were selected as the control group.The levels of serum prolactin,progesterone,and estradiol in the study subjects were tested and compared.A logistic regression model was used to analyze the risk factors for progressive stroke in patients with acute ischemic stroke.Pearson′s correlation coefficient was used to analyze the correlation between sex hormone levels and disease severity.The receiver operating(ROC)curves were used to evaluate the diagnostic value of sex hormones in progressive stroke.Results Prolactin and progesterone levels were gradually increased in the control group,ischemic stroke group,and progressive stroke group,with statistically significant differences(P<0.05).There was no significant difference in estradiol level between ischemic stroke group and progressive stroke group(P>0.05),but it was significantly higher than that of control group(P<0.05).Univariate and multivariate regression analysis showed that prolactin and progesterone were risk factors for progressive stroke in patients with acute ischemic stroke(P<0.05).Prolactin and progesterone levels were positively correlated with the severity of the disease(P<0.05),but the level of estradiol did not show a significant correlation with the severity of the disease(P>0.05).The ROC curve analysis found that the area under the curve of prolactin and progesterone were 0.905 and 0.937,respectively.Conclusions Progesterone and prolactin levels are risk factors for progressive stroke in patients with acute ischemic stroke,which are positively correlated with the severity of the disease and can be used as references for the diagnosis of progressive stroke.