常见实验室指标与初发脑梗死患者预后关系研究

Study on the relationship between common laboratory indicators and the prognosis of patients with initial cerebral infarction

目的通过观察初发脑梗死患者的常见实验室指标变化,进一步探讨影响初发脑梗死患者预后的危险因素。方法选取初次诊断为脑梗死的住院患者94例作为研究对象,收集其一般情况(性别和年龄)、既往史(吸烟、饮酒、高血压、糖尿病、冠心病、心房颤动)及入院24 h内的实验室指标;随访6个月,根据改良Rankin量表(mRS)评分标准对患者预后进行评价,mRS评分>2分为预后不良组(42例),≤2分为预后良好组(52例),对两组患者的观察指标进行统计分析。结果预后不良组高血压患者比例、白细胞计数、血小板计数、中性粒细胞百分比、D-二聚体、纤维蛋白原、超敏C反应蛋白、空腹血糖、肌红蛋白水平均高于预后良好组,红细胞计数、血红蛋白、淋巴细胞百分比水平均低于预后良好组,差异有统计学意义(P<0.05)。纤维蛋白原和空腹血糖水平是影响初发脑梗死患者预后的独立危险因素(P<0.05)。结论纤维蛋白原和空腹血糖升高是初发脑梗死患者预后不良的独立危险因素,监测这两项指标有助于临床对初发脑梗死患者的预后评估及治疗。

Objective To observe the changes of common laboratory indicators in patients with initial cerebral infarction,further explore the risk factors that affect the prognosis of patients with initial cerebral infarction.Methods A total of 94 hospitalized patients with initial diagnosis of cerebral infarction were selected as research object.The general information(gender and age),past history(smoking,drinking,hypertension,diabetes,coronary heart disease and atrial fibrillation)and laboratory indicators within 24 hours after admission were collected;followed up for 6 months,the prognosis of the patients was evaluated according to the modified Rankin Scale(mRS)scoring standard,the mRS score>2 was divided into the poor prognosis group(42 cases),≤2 was divided into the good prognosis group(52 cases),and the observation indexes of the two groups were statistically analyzed.Results The proportion of patients with hypertension,white blood cell count,platelet count,neutrophil percentage and the level of D-dimer,fibrinogen,high sensitivity C reactive protein,fasting blood glucose,myoglobin in the poor prognosis group were higher than those in the good prognosis group,while the red blood cell count,hemoglobin and lymphocyte percentage were lower than those in the good prognosis group(P<0.05).Fibrinogen and fasting blood glucose levels were independent risk factors for the prognosis of patients with initial cerebral infarction(P<0.05).Conclusion Fibrinogen and fasting blood glucose levels are independent risk factors for the prognosis of patients with initial cerebral infarction.It is helpful to evaluate the prognosis and treatment of patients with initial cerebral infarction by monitoring these two indicators.