HALP+NIHSS评分对大动脉粥样硬化型脑梗死患者预后的预测价值

VALUE OF HALP+NIHSS SCORE IN PREDICTING THE PROGNOSIS OF PATIENT WITH LARGE ARTERY ATHEROSCLEROSIS CEREBRAL INFARCTION

目的探讨HALP+NIHSS评分对大动脉粥样硬化(large artery atherosclerosis,LAA)型脑梗死患者预后的预测价值。方法回顾性分析2020年1月-2021年10月于我院确诊的500例LAA型脑梗死患者的临床资料。在发病后第30天时通过改良Rankin量表(mRS)进行临床转归评估,根据mRS评分结果分为预后良好组(mRS评分≤2分)和预后不良组(mRS评分>2分),对两组患者的临床资料进行比较。采用Logistic回归分析评价影响LAA型脑梗死患者预后不良发生的因素,并通过受试者工作特征曲线(ROC)分析NISHH评分、HALP评分及NISHH+HALP评分对LAA型脑梗死患者预后的预测价值。结果多因素Logistic回归分析显示,高龄、高血压、NIHSS评分高、LDL水平升高为LAA型脑梗死患者预后不良的危险因素(P<0.05);HALP评分的升高为影响LAA型脑梗死患者预后不良发生的保护因素(P<0.05)。ROC曲线分析显示,HALP+NIHSS评分联合预测价值显著优于HALP评分和NIHSS评分(P<0.05),HALP+NIHSS评分曲线下面积为0.879(95%CI=0.849~0.910)。结论HALP+NIHSS评分对LAA型脑梗死患者的预后有一定的预测价值。

Objective To investigate the value of HALP+NIHSS score in predicting the prognosis of patients with large artery atherosclerosis(LAA)cerebral infarction.Methods A retrospective analysis was performed for the clinical data of 500 patients who were diagnosed with LAA cerebral infarction in our hospital from January 2020 to October 2021.On day 30 after di-sease onset,modified Rankin Scale(mRS)score was used to evaluate clinical outcome,and according to the mRS score,the patients were divided into good prognosis group(mRS score≤2)and poor prognosis group(mRS score>2).Related clinical data were compared between the two groups.A logistic regression analysis was used to evaluate the influencing factors for poor prognosis in patients with LAA cerebral infarction,and the receiver operating characteristic(ROC)curve was plotted to analyze the value of NIHSS score,HALP score,and NIHSS+HALP score in predicting the prognosis of patients with LAA cerebral infarction.Results The multivariate logistic regression analysis showed that old age,hypertension,high NIHSS score,and increased low-density lipoprotein level were risk factors for poor prognosis in patients with LAA cerebral infarction(P<0.05),while the increase in HALP score was a protective factor against poor prognosis in patients with LAA cerebral infarction(P<0.05).The ROC curve analysis showed that HALP+NIHSS score had a significantly better predictive value than HALP score and NIHSS score(P<0.05),with an area under the ROC curve of 0.879(95%CI=0.849-0.910).Conclusion HALP+NIHSS score has a certain value in predicting the prognosis of patients with LAA cerebral infarction.