HR-NICE进展的影响因素及血清Hcy的预测价值

Influencing Factors of HR-NICE Progression and Predictive Value of Serum Hcy

目的:探究高危非致残性缺血性脑血管事件(HR-NICE)进展的影响因素及血清同型半胱氨酸(Hcy)的预测价值。方法:回顾性收集2020年5月─2021年7月于中江县人民医院神经内科住院的248例HR-NICE患者的临床资料,根据患者发病l周内出现症状加重或复发,NIHSS评分增加>2分;或有新发缺血性脑卒中、周围血管事件、心血管事件等情况将其分为HR-NICE稳定组(n=182)及HR-NICE进展组(n=66例),对比两组患者一般资料及实验室检验指标,将差异有统计学意义的指标进行logistic回归分析,绘制受试者工作特征(ROC)曲线确定Hcy对HR-NICE患者早期进展风险的最佳截断值。结果:两组高密度脂蛋白胆固醇、低密度脂蛋白胆固醇、甘油三酯、血尿酸、入院时美国国立卫生研究院卒中量表(NIHSS)评分、入院时ABCD2评分、高血压、糖尿病、冠心病、吸烟史、饮酒史及家族史比较,差异无统计学意义(P>0.05),两组年龄、总胆固醇、Hcy比较,差异有统计学意义(P<0.05)。logistic回归分析结果显示,Hcy为HR-NICE病程进展的危险因素;Hcy评估HR-NICE进展的AUC为0.785;以>15μmol/L为截断值,Hcy鉴定HR-NICE进展的敏感度、特异度分别为87.10%、65.70%。结论:Hcy为HR-NICE病程进展的危险因素,且对HR-NICE诊断及病情评估有较高的价值。

Objective:To investigate the influencing factors of high-risk non-disabling ischemic cerebrovascular events(HR-NICE)progression and predictive value of serum homocysteine(Hcy).Method:Clinical data of 248 HR-NICE patients admitted to the Department of Neurology of Zhongjiang County People's Hospital from May 2020 to July 2021 were retrospectively collected.According to the aggravation or recurrence of symptoms in patients within the first week of onset,NIHSS score increased by>2 points,patients with new ischemic stroke,peripheral vascular events and cardiovascular events were divided into HR-NICE stable group(n=182)and HR-NICE progressive group(n=66).General data and laboratory test indicators of the two groups of patients were compared,logistic regression analysis was performed on indicators with statistically significant differences,and receiver operating characteristic(ROC)curve was drawn to determine the optimal cut-off value of Hcy for early progression risk of HR-NICE patients.Result:There were no significant differences in high density lipoprotein cholesterol,low density lipoprotein cholesterol,triglyceride,blood uric acid,National Institute of Health stroke scale(NIHSS)score on admission,ABCD2 score on admission,hypertension,diabetes,coronary heart disease,smoking history,drinking history and family history between the two groups(P>0.05).There were statistically significant differences in age,total cholesterol and Hcy between the two groups(P<0.05).logistic regression analysis showed that Hcy was a risk factor for the progression of HR-NICE.The AUC for Hcy evaluation of HR-NICE progress was 0.785;with>15μmol/L as the cut-off value,the sensitivity and specificity of HR-NICE progression were 87.10%and 65.70%,respectively.Conclusion:Hcy is a risk factor for HR-NICE progression,and it is of high value in the diagnosis and evalu ation of HR-NICE.