卒中患者静脉溶栓转归的影响因素及MPV与RDW对其预测价值

Influencing factors of the outcome of intravenous thrombolysis in stroke patients and the predictive value of MPV and RDW

目的探究卒中患者静脉溶栓转归的影响因素及MPV与RDW对其预测价值。方法选取2019年1月至2020年12月淮南东方医院集团总院神经内科收取的卒中患者102例,采用静脉溶栓治疗。六个月后使用MRS评分,分为转归良好组(MRS≤1且≥0)76例,转归不良组(MRS≥2分)26例;分析转归的单因素影响;采用最佳刻度分析卒中静脉溶栓后转归的多因素影响;ROC曲线分析RDW、MPV对该病预测价值。结果治疗前,两组性别、年龄、吸烟史、饮酒史、冠心病、高血压、SBP、WBC、Hb、PLT比较,差异无统计学意义(P>0.05),治疗后,转归良好组DBP、高血脂、NIHSS评分、RDW、MPV较于转归不良组明显更低,差异有统计学意义(均P<0.05)。ROC曲线分析显示,RDW、MPV、二者联合诊断均具有预测价值(P<0.05),高血脂、DBP、RDW、MPV均为影响卒中转归的不良因素(P<0.05);转归良好组高血脂、NIHSS评分、RDW、MPV较于转归不良组明显更低,差异有统计学意义(均P<0.05)。结论 RDW、MPV均可以作为预测卒中患者静脉溶栓转归的指标。

Objective To explore the factors influencing the outcome of intravenous thrombolysis in stroke patients and the predictive value of MPV and RDW. Methods 102 cases of stroke patients collected from the Department of Neurology of Huainan Oriental Hospital Group from January 2019 to December 2020 were selected and treated with intravenous thrombolysis. Six months later,the MRS score was divided into 76 good patients(MRS ≤ 1 and ≥ 0)and 26 poor patients(MRS ≥ 2);the univariate effect of transposition;multivariate effect of regression after stroke vein thrombolysis and the predictive value of RDW,MPV on ROC curve. Results Before treatment,gender,age,smoking history,alcohol history,CHD,hypertension,SBP,WBC,Hb and PLT were not significant(P>0.05). After treatment,DBP,hyperlipidemia,NIHSS score,RDW and MPV in the good outcome group were significantly lower than those in the poor outcome group,and the differences were statistically significant(P<0.05). ROC curve analysis showed that RDW,MPV and combined diagnosis had predictive value(P<0.05),and hyperlipidemia,DBP,RDW and MPV were adverse factors affecting stroke outcome(P<0.05);hyperlipidemia,NIHSS score,RDW and MPV were significantly lower than those those in the poor outcome group(P<0.05). Conclusion Both RDW and MPV can be used as indicators to predict intravenous thrombolytic regression in stroke patients.