| 夏 瑜,康艳飞,曹敬然,孙 明,王玉红.RDW联合血清CRP、PCT、sTLT-1与急性脑梗死患者脑梗死体积、神经功能受损程度和预后的关系研究[J].,2022,(12):2356-2360 |
| RDW联合血清CRP、PCT、sTLT-1与急性脑梗死患者脑梗死体积、神经功能受损程度和预后的关系研究 |
| Relationship between RDW Combined with Serum CRP, PCT, sTLT-1 and Cerebral Infarction Volume, Neurological Impairment and Prognosis in Patients with Acute Cerebral Infarction |
| 投稿时间：2021-11-23 修订日期：2021-12-17 |
| DOI：10.13241/j.cnki.pmb.2022.12.032 |
| 中文关键词: RDW CRP PCT sTLT-1 急性脑梗死 脑梗死体积 神经功能受损程度 预后 |
| 英文关键词: RDW CRP PCT sTLT-1 Acute cerebral infarction Cerebral infarction volume Degree of neurological impairment Prognosis |
| 基金项目:北京市科技计划项目（ZI81100001718024） |
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| 中文摘要: |
| 摘要 目的：观察红细胞分布宽度（RDW）联合血清C反应蛋白（CRP）、降钙素原（PCT）、可溶性骨髓细胞样转录因子-1（sTLT-1）与急性脑梗死（ACI）患者脑梗死体积、神经功能受损程度和预后的关系。方法：选择我院2019年4月至2021年10月期间收治的100例ACI患者作为研究对象，将100例患者根据入院时美国国立卫生研究院卒中量表（NIHSS）评分分为轻中度损伤组（61例，NIHSS≤15分）和重度损伤组（39例，NIHSS>15分）；根据不同脑梗死体积分为小灶梗死组（41例，梗死体积<5 cm3）、中灶梗死组（35例，5 cm3≤梗死体积≤15 cm3）、大灶梗死组（24例，梗死体积>15 cm3）；根据出院时改良Rankin量表（mRS）分为预后不良组（31例，mRS>3分）和预后良好组（69例，mRS≤3分）。对比不同脑梗死体积、不同NIHSS评分、不同预后ACI患者的RDW和血清CRP、PCT、sTLT-1水平，ACI患者预后不良的影响因素采用单因素及多因素Logistic回归分析。结果：小灶梗死组、中灶梗死组、大灶梗死组患者的RDW和血清CRP、PCT、sTLT-1依次升高，组间对比差异均有统计学意义（P<0.05）。重度损伤组的RDW和血清CRP、PCT、sTLT-1水平高于轻中度损伤组（P<0.05）。预后不良组的RDW和血清CRP、PCT、sTLT-1水平高于预后良好组（P<0.05）。预后良好组、预后不良组在脑梗死分型、吸烟史、性别、入院时NIHSS评分、年龄、梗死体积、饮酒史方面对比差异有统计学意义（P<0.05）。多因素Logistic回归分析结果显示：入院时NIHSS评分偏高、梗死体积偏大、脑梗死分型为完全前循环脑梗死、RDW偏高、CRP偏高、PCT偏高、sTLT-1偏高是ACI患者预后不良的危险因素（P<0.05）。结论：RDW和血清CRP、PCT、sTLT-1水平可有效反映ACI患者脑梗死体积、神经功能受损程度，且ACI患者的预后受到入院时NIHSS评分、梗死体积、脑梗死分型、RDW、CRP、PCT、sTLT-1等多种因素的影响。 |
| 英文摘要: |
| ABSTRACT Objective: To observe the relationship between red blood cell distribution width (RDW) combined with serum C-reactive protein (CRP), procalcitonin (PCT), soluble bone marrow cell like transcription factor-1 (sTLT-1) and cerebral infarction volume, neurological impairment and prognosis in patients with acute cerebral infarction (ACI). Methods: 100 patients with ACI who were treated in our hospital from April 2019 to October 2021 were selected as the research object. 100 patients were divided into mild to moderate injury group (61 cases, NIHSS ≤ 8 scores) and severe injury group (39 cases, NIHSS > 8 scores) according to the National Institutes of Health Stroke Scale (NIHSS), small focal infarction group (41 cases, infarct volume < 5 cm3), medium focal infarction group (35 cases, 5 cm3 ≤ infarct volume ≤15 cm3) and large focal infarction group (24 cases, infarct volume > 15 cm3) according to different volume of cerebral infarction. poor prognosis group (31 cases, mRS ≥3 scores) and good prognosis group (69 cases, mRS < 3 scores) according to the modified Rankin Scale (mRS) at discharge. The RDW and the serum CRP, PCT and sTLT-1 levels with different cerebral infarction volume, different NIHSS score and different prognosis in patients with ACI were compared. The influencing factors of poor prognosis in patients with ACI were analyzed by univariate and multivariate Logistic regression. Results: RDW, serum CRP, PCT and stlt-1 increased in turn of patients in small focal infarction group, medium focal infarction group and large focal infarction group, and the difference between the groups was statistically significant(P<0.05). The RDW and serum CRP, PCT, sTLT-1 levels in severe injury group were higher than those in mild to moderate injury group (P<0.05). The RDW and serum CRP, PCT, sTLT-1 levels in the poor prognosis group were higher than those in the good prognosis group (P<0.05). There were significant differences in classification of cerebral infarction, smoking history, gender, NIHSS score at admission, age, infarct volume and drinking history between the good prognosis group and the poor prognosis group (P<0.05). Multivariate Logistic regression analysis showed that higher NIHSS score at admission, larger cerebral infarction volume, complete anterior circulation cerebral infarction, higher RDW, higher CRP, higher PCT and higher sTT-1 were the risk factors for poor prognosis of patients with ACI (P<0.05). Conclusion: RDW and the serum CRP, PCT, sTLT-1 levels can effectively reflect the cerebral infarction volume and the degree of neurological impairment in patients with ACI, and the prognosis of patients with ACI is affected by NIHSS score, cerebral infarction volume, cerebral infarction classification, RDW, CRP, PCT, sTLT-1 and other factors. |
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