呼吸暂停低通气指数对急性缺血性脑卒中短期预后的预测价值

Predictive value of AHI for short-term prognosis of AIS

目的 探讨呼吸暂停低通气指数(AHI)对急性缺血性脑卒中(AIS)预后的预测价值。方法 纳入2018年1月~2022年2月郑州市第三人民医院神经内科收治的AIS患者193例,根据随访3个月改良的Rankin量表(mRS)评分分为预后良好组(mRS评分≤2分)121例和预后不良组(mRS评分>2分)72例,对比2组间AHI、入院时美国国立卫生研究院卒中量表评分等差异。采用ROC曲线分析AHI对AIS发病后3个月预后的预测作用。结果 预后不良组年龄和AHI明显高于预后良好组(P<0.05,P<0.01)。年龄(OR=1.108,95%CI:1.031~1.190,P=0.005),AHI(OR=1.060,95%CI:1.018~1.103,P=0.004)是AIS发病3个月预后不良的危险因素。用于预测AIS发病后3个月预后不良的AHI最佳截断值为19.2次/h, ROC曲线下面积为0.640(95%CI:0.536~0.745,P=0.012)。结论 AHI是AIS发病后3个月预后的独立预测因子,AHI升高提示患者预后不良。

Objective To investigate the predictive value of apnea-hypopnea index(AHI) in the prognosis of AIS.Methods A total of 193 patients with AIS admitted to the Department of Neurology, Zhengzhou Third People’s Hospital from January 2018 to February 2022 were enrolled.According to the mRS score after 3 months of follow-up, the patients were divided into a good prognosis group(mRS score ≤2,n=121) and a poor prognosis group(mRS score >2,n=72).Their AHI,and NIHSS score at admission were compared between two groups.The predictive effect of AHI on the prognosis of AIS in 3 months after AIS onset was analyzed by ROC curve.Results Compared with the good prognosis group, the poor prognosis group had older age and higher AHI(P<0.05,P<0.01).The age(OR=1.108,95%CI:1.031-1.190,P=0.005) and AHI(OR=0.060,95%CI:1.018-1.103,P=0.004) were risk factors for poor prognosis in AIS patients in 3 months after onset.The ROC curve analysis indicated that the AHI cut-off value for predicting poor prognosis in 3 months after AIS onset was 19.2 times/h, the area under curve was 0.640(95%CI:0.536-0.745,P=0.012).Conclusion AHI is an independent predictor of prognosis in 3 months after the onset of AIS,and elevated AHI indicates poor prognosis.