Hcy、FIB联合NT-proBNP检测在老年脑梗死远期预后预测中的效能

Efficacy of Hcy and FIB combined with NT-proBNP Detection in Prediction of the Long-term Prognoses of Elderly Patients with Cerebral Infarction

目的研究治疗前同型半胱氨酸(Hcy)、纤维蛋白原(FIB)联合N末端脑钠肽前体(NT-proBNP)检测在老年脑梗死远期预后预测中的效能。方法选取2017年5月—2019年8月收治的109例老年脑梗死作为研究组,根据美国国立卫生研究院卒中量表(NIHSS)评分分为轻度组42例、中度组35例和重度组32例。同时选取128例健康体检者作为对照组。比较不同研究对象Hcy、FIB、NT-proBNP水平差异。统计研究组远期预后情况,多因素Logistic回归分析影响远期预后的相关因素;受试者工作特征(ROC)曲线分析Hcy、FIB、NT-proBNP对患者远期预后的预测价值。结果研究组Hcy、FIB、NT-proBNP水平高于对照组(P<0.01)。中度组和重度组Hcy、FIB、NT-proBNP水平高于轻度组,且重度组高于中度组(P<0.05)。NIHSS评分、Hcy、FIB、NT-proBNP异常升高均为影响老年脑梗死患者远期预后的独立危险因素(P<0.01)。Hcy、FIB、NT-proBNP及三者联合预测老年脑梗死患者远期预后的曲线下面积分别为0.801、0.812、0.844及0.917,以三者联合最大。结论治疗前Hcy、FIB、NT-proBNP水平在老年脑梗死患者中随神经功能缺损严重程度增加而升高,且是影响患者远期预后的独立危险因素,并有一定预测价值。

Objective To study the efficacy of homocysteine(Hcy)and fibrinogen(FIB)combined with N-terminal pro-brain natriuretic peptide(NT-proBNP)detection before treatment in prediction of the long-term prognoses of elderly patients with cerebral infarction.Methods A total of 109 elderly patients with cerebral infarction admitted between May 2017 and August 2019 were selected as research group,and the patients were divided into mild subgroup(n=42),moderate subgroup(n=35)and severe subgroup(n=32)according to the National Institute of Health Stroke Scale(NIHSS)score.In the meantime,128 healthy people undergoing physical examinations were selected as the control group.Levels of Hcy,FIB,and NT-proBNP were compared in different groups.Conditions of long-term prognoses of patients in research group were analyzed,and multivariate Logistic regression was used to analyze the related factors affecting the long-term prognoses.The receiver operating characteristic(ROC)curve was used to analyze the predictive values of serum Hcy,FIB and NT-proBNP in prediction of the long-term prognoses of elderly patients with cerebral infarction.Results Levels of Hcy,FIB and NT-proBNP in research group were significantly higher than those in control group(P<0.01).Levels of Hcy,FIB and NT-proBNP in moderate and severe subgroups were significantly higher than those in mild subgroup,and the levels in severe subgroup were significantly higher than those in moderate subgroup(P<0.05).Abnormal increasing NIHSS score,and levels of Hcy,FIB and NT-proBNP were independent risk factors affecting the long-term prognoses of patients with cerebral infarction(P<0.01).The areas under ROC curves(AUC)of Hcy,FIB,NT-proBNP and the combined detection of the three indexes in prediction of the long-term prognoses of elderly patients with cerebral infarction were 0.801,0.812,0.844 and 0.917 respectively,and the AUC of the combined detection of the three indexes was the largest.Conclusion Levels of Hcy,FIB,and NT-proBNP increase with the increasing severity of neurologic impairment before treatment,which are independent risk factors affecting the long-term prognoses of elderly patients,and they have a certain predictive values.