预后营养指数对老年脑卒中的预后评估价值分析

Analysis of prognostic evaluation value of prognostic nutrition index in elderly patients with cerebral apoplexy

目的探究预后营养指数(PNI)对老年脑卒中(CS)患者的预后评估价值及影响因素,分析PNI作为脑卒中结局现状及影响预后指标的作用价值。方法回顾性分析2015年12月至2019年6月收治的356例老年脑卒中患者的临床资料,根据PNI分为PNI≥45组(154例)和PNI<45组(202例),通过单因素和多因素分析评价老年脑卒中预后现状及影响因素,并分析其预测价值。结果一般资料显示,PNI<45组患者比PNI≥45组患者具有更高的年龄、体质量指数(BMI)、高血清总蛋白(TP)、血清白蛋白(ALB)、外周血淋巴细胞计数(LYMPH)含量、高三酰甘油(TG)、高空腹血糖(GLU)、低BMI、高改良Rankin量表(MRS)评分,差异有统计学意义(χ^2值为0.005~0.083,t值为0.037~1.455,均P<0.05)。多因素分析结果显示,PNI(HR=1.43,95%CI 0.94~2.25,P<0.01,标准化偏回归系数为0.051)的贡献度最高,是预测术后的独立危险因素。且Kappa系数提示,PNI与MRS筛查评定结果具有一致性(P<0.01)。结论PNI是影响老年CS患者预后的独立影响因素,对老年CS患者预后情况评估及影响因素分析具有重要意义,为临床护理提供新思路。

Objective To explore the prognostic evaluation value and influencing factors of prognostic nutritional index(PNI)in elderly patients with stroke,and to analyze the value of PNI as an indicator of stroke outcome and prognosis.Methods The clinical data of 356 elderly patients with cerebral apoplexy treated in hospital from December 2015 to June 2019 were analyzed retrospectively.According to PNI index,there were 154 cases of PNI≥45 and 154 cases of PNI.Results General data showed that patients with PNI<45 had higher age,body mass index(BMI),TP,ALB,lymph,TG,Glu,BMI and Mrs scores than those with PNI≥45,The difference was statistically significant(χ^2 values were 0.005-0.083,t values were 0.037-1.455,P<0.05).The results of multivariate analysis showed that PNI(HR value was 1.43,95%CI 0.94-2.25,P<0.01,standardized partial regression coefficient was 0.051)had the highest contribution and was an independent risk factor for prediction of postoperative risk.Moreover,kappa coefficient indicated that PNI was consistent with MRS(P<0.01).Conclusions PNI is an independent factor affecting the prognosis of elderly patients with CS,which is of great significance to the evaluation of prognosis and analysis of influencing factors in elderly patients with CS.