甘油三酯葡萄糖指数及预后营养指数对重症急性脑梗死患者预后的预测价值

Prognostic value of TyG and PNI in patients with severe acute cerebral infarction

目的分析甘油三酯葡萄糖指数(TyG)、预后营养指数(PNI)对重症急性脑梗死患者预后的预测价值。方法本研究为前瞻性病例对照研究,收集2022年6月—2023年9月在华北理工大学附属医院神经重症医学科住院的288例重症急性脑梗死(ACI)患者为研究对象,依据3个月预后结局分为预后良好组182例和预后不良组106例。记录并比较不同组间患者一般资料及TyG、PNI水平,运用多因素Logistic回归分析重症ACI患者预后不良的危险因素,运用Spearman相关系数分析TyG、PNI与预后之间的相关性,采用ROC曲线分析TyG、PNI对重症ACI患者预后的预测效能。结果288例重症ACI患者中,预后良好者182例,预后不良者106例。预后良好组和预后不良组患者的TyG、PNI比较,差异均有统计学意义(P<0.05);Logistic回归分析显示,TyG、PNI均为重症ACI患者预后的独立危险因素(P<0.05);Spearman相关系数分析表明TyG与患者预后不良呈正相关(r=0.376,P<0.01),PNI与预后不良呈负相关(r=-0.413,P<0.01);ROC曲线分析结果显示,TyG、PNI及联合预测重症ACI患者预后不良的曲线下面积(AUC)为0.725、0.747、0.810,联合预测的AUC最大(P<0.001),其灵敏度及特异度均较高。结论TyG、PNI对重症急性脑梗死患者的3个月预后不良具有一定的预测价值,且两项指数联合评估的预测价值更高。

Objective To analyze the prognostic value of triglyceride glucose index(TyG)and prognostic nutritional index(PNI)in patients with severe acute cerebral infarction.Methods A prospective case-control study was conducted.Two hundred and eighty-eight patients with severe acute cerebral infarction(ACI)hospitalized in Department of Neurocritical Medicine,Affiliated Hospital of North China University of Science and Technology from June 2022 to September 2023 were enrolled.According to 3-month prognosis,they were divided into good prognosis group(n=182)and poor prognosis group(n=106).General data and levels of TyG and PNI in different groups were recorded and compared.The risk factors of poor prognosis in patients with severe ACI were evaluated by multivariate Logistic regression.Spearman correlation coefficient was used to analyze correlation between TyG,PNI and prognosis.ROC curve analysis was used to compare the predictive efficiency of TyG and PNI in prognosis of patients with severe ACI.Results Among 288 patients with severe ACI,182 had a good prognosis and 106 had a poor prognosis.There was statistical significance in TyG and PNI between good prognosis group and poor prognosis group(P<0.05).Logistic regression analysis revealed that TyG and PNI were independent risk factors for the prognosis of patients with severe ACI(P<0.05).Spearman correlation coefficient analysis showed that TyG was positively correlated with poor prognosis(r=0.376,P<0.01),while PNI was negatively correlated with poor prognosis(r=-0.413,P<0.01).ROC curve analysis results indicated that the area under curve(AUC)of TyG,PNI and combined prediction of poor prognosis in patients with severe ACI were 0.725,0.747 and 0.810.The combined prediction of AUC was the largest(P<0.001),and its sensitivity and specificity were higher.Conclusion TyG and PNI have a certain predictive value for 3-month poor prognosis of patients with severe acute cerebral infarction,and the combined evaluation of the two indexes has a higher predictive value.