血管生成素2对老年急性缺血性脑卒中患者预后的影响

Effect of ANG-2 on Prognosis of Elderly Patients with Acute Ischemic Stroke

[目的]探究血管生成素2(Angiopoietin-2,ANG-2)对老年急性缺血性脑卒中(acute ischemic stroke,AIS)患者预后的影响。[方法]选取2016年12月30日至2018年6月30日在本院接受治疗的160例老年(年龄≥65岁)AIS患者,检测入院时其外周血中ANG-2水平。对患者进行随访,随访截止日期为2019年4月30日,随访终点为死亡。观察ANG-2与老年AIS患者死亡的相关性,并分析其预后的影响因素,使用ROC曲线评估ANG-2对死亡预测价值。[结果]入院时NIHSS评分>14分患者ANG-2水平高于NIHSS评分≤14分者,差异有统计学意义(P<0.05)。ROC曲线下面积为0.73,当ANG-2界值为25.2 ng/L时,ANG-2诊断死亡的特异度和灵敏度分别为63.4%.81.2%。中位随访时间16.9个月,共35例患者死亡。死亡组年龄、脑卒中史比例、合并房颤比例、脑疝发生率、总胆固醇、治疗前NIHSS评分、ANG-2水平均高于存活组,差异有统计学意义(P<0.05)。多因素分析显示,年龄、合并脑疝、总胆固醇、治疗前NIHSS评分、ANG-2(P=0.040,OR:1.244,95%CI:1.055~2.197)是老年AIS患者死亡的独立影响因素(P<0.05)。[结论]入院时ANG-2水平可预测老年AIS患者预后,ANG-2水平升高者预后不良。

[Objective]To explore the correlation between angiopoietin-2(Ang-2)and the prognosis of elderly patients with acute ischemic stroke(AIS).[Methods]A total of 160 elderly patients with acute ischemic stroke who were treated in our hospital from December30,2016 to June 30,2018,aged≥65 years,were enrolled.The level of ANG-2 in peripheral blood was measured at admission.Patients were followed up.The follow up deadline was April 30,2019,and the end of follow up was death.The correlation between ANG-2 and death in elderly patients with acute ischemic stroke was observed,and the prognostic factors were analyzed.The ROC curve was used to evaluate the predictive value of ANG-2 for death.[Results]At the time of admission,the ANG-2 level in patients with NIHSS score:>14 points was higher than that in patients with NIHSS score≤14 points,the difference was statistically significant(P<0.05).The ar-ea under the ROC curve was 0.73.When the ANG-2 threshold was 25.2 ng/L.the specificity and sensitivity of ANG 2 diagnosis of death were 63.4%and 81.2%,respectively.The median follow-up time was 16.9 months and a total of 35 patients died.The age,proportion of stroke history and atrial fibillation,the incidence of cerebral palsy,total cholester.ol,pre treatment NIHSS score,and ANG 2 level in the death group were higher than those in the survival group(P<0.05).Multivariate analysis showed that age,cerebral palsy,total cholesterol,pre-treatment NIHSS score,ANG-2(P=0.040,OR:1.244,95%CI:1.055-2.197)were independent influence factors of deaths in elderly patients with acute is-chemic stroke(P<0.05).[Conclusion]The ANG 2 level at admission can predict the prognosis of elderly patients with acute ischemic stroke,and the patients with elevated ANG 2 have a poor prognosis.