那不勒斯预后评分与高血压性脑出血预后关系的研究

The Relationship between the Naples Prognostic Score and Prognosis of Hypertensive Intracerebral Hemorrhage

目的:探讨那不勒斯预后评分(Naples prognostic score, NPS)与高血压性脑出血预后的相关性。方法:回顾性分析2021年9月至2022年9月在重庆医科大学附属第二医院神经外科就诊的272名脑出血患者的临床数据。使用患者入院24小时内收集的血清学数据分别计算NPS、控制营养状况评分(CONUT)和预后营养指数(PNI)。根据改良的Rank评分(mRS),评估6个月的结局。使用多因素logistic回归分析影响高血压脑出血患者预后不良的危险因素。使用Dlong检验比较不同指标预测不良预后的ROC曲线下面积(AUC),以此来比较其预测性能。结果:在单因素分析中,不良组患者的NPS评分较高(P < 0.001)。多变量分析显示,在调整潜在混杂因素后,NPS仍然是不良结局的独立预测因子(P < 0.001)。NPS预测不良预后的AUC数值明显高于其他指标(P < 0.05)。结论:NPS可能是脑出血患者预后的新的预测评分系统,且比其他评分系统具有更强大的预测性能。

Objective: To investigate the correlation between the Naples prognostic score (NPS) and the prognosis of hypertensive cerebral hemorrhage. Methods: The clinical data of 272 patients with cerebral hemorrhage who attended the Department of Neurosurgery of the Second Affiliated Hospital of Chongqing Medical University from September 2021 to September 2022 were retrospectively analyzed. NPS, controlled nutritional status score (CONUT), and prognostic nutrition index (PNI) were calculated using serological data collected within 24 hours of patient admission. Outcomes were assessed according to the modified Rank score (mRS). Multivariate logistic regression was used to analyze risk factors for poor prognosis in patients with hypertensive cerebral hemorrhage. The area under the R OC curve (AUC) for predicting poor prognosis was used to compare their predictive performance. Results: In univariate analysis, patients in the unfavoura-ble group had a higher NPS score (P < 0.001). Multivariate analysis showed that NPS remained an independent predictor of unfavourable outcomes after adjusting for potential confounding factors (P < 0.001). The AUC value of NPS predicting poor prognosis was significantly higher than that of other indicators (P < 0.05). Conclusion: NPS may be a new predictive scoring system for the prognosis of patients with cerebral hemorrhage, and has more powerful predictive performance than other scoring systems.