踝臂指数与动脉瘤性蛛网膜下腔出血后迟发性脑梗死的关系研究  

Relationship between ABI and Delayed Cerebral Infarction in Patients with Aneurysmal Subarachnoid Hemorrhage

作　　者：韦玮[1,2] 杨延庆 黄元志[1,2] 刘赟 张春满[1] 郑云峰[1] 曹慧琴[3] 

机构地区：[1]延安大学附属医院神经外科,陕西省延安市716000 [2]延安大学医学院,陕西省延安市716000 [3]延安大学附属医院血液科,陕西省延安市716000

出　　处：《实用心脑肺血管病杂志》2017年第10期28-31,共4页Practical Journal of Cardiac Cerebral Pneumal and Vascular Disease

摘　　要：目的探讨踝臂指数(ABI)与动脉瘤性蛛网膜下腔出血(aSAH)后迟发性脑梗死(DCI)的关系。方法选取2015年1月—2017年3月延安大学附属医院神经外科收治的aSAH患者114例,根据DCI发生情况分为DCI组28例和非DCI组86例。比较两组患者临床特征,aSAH后DCI的影响因素分析采用多因素Logistic回归分析,绘制ROC曲线以评价ABI对aSAH后DCI的预测价值。结果两组患者体温≥37.4℃者所占比例、Fisher分级、ABI比较,差异有统计学意义(P<0.05);两组患者男性比例、吸烟率、高血压发生率、糖尿病发生率、血脂异常发生率、手术方式、手术时机、动脉瘤位置、动脉瘤直径、Hunt-Hess分级及年龄、体质指数、收缩压、舒张压、空腹血糖、三酰甘油、低密度脂蛋白胆固醇比较,差异均无统计学意义(P>0.05)。多因素Logistic回归分析结果显示,体温≥37.4℃[OR=1.623,95%CI(1.118,2.355)]、Fisher分级[OR=1.742,95%CI(1.429,2.123)]、ABI[OR=0.719,95%CI(0.478,0.888)]是aSAH后DCI的影响因素(P<0.05)。绘制ROC曲线显示,ABI预测aSAH后DCI的曲线下面积为0.669[95%CI(0.544,0.794)],最佳截断值为0.965,灵敏度为0.872,特异度为0.429,约登指数为0.301。结论 ABI是aSAH后DCI的影响因素,其对aSAH后DCI有一定的预测价值。Objective To investigate the relationship between ABI and delayed cerebral infarction（ DCI） in patients with aneurysmal subarachnoid hemorrhage（ aSAH）. Methods From January 2015 to March 2017,a total of 114 patients with aSAH were selected in the Department of Neurosurgery,the Affiliated Hospital of Yan＇an University,and they were divided into A group（ complicated with DCI,n = 28） and B group（ did not complicate with DCI,n = 86） according to the incidence of DCI. Clinical features were compared between the two groups,multivariate Logistic regression analysis was used to analyze the influencing factors of DCI in patients with aSAH,and ROC curve was drawn to evaluate the predictive value of ABI on DCI in patients with aSAH. Results There were statistically significant differences of proportion of patients with body temperature equal or over 37. 4 ℃,Fisher grading and ABI（ P〈0. 05）,while no statistically significant differences of male proportion,smoking rate,incidence of hypertension,diabetes or dyslipidemia,surgical procedures,operation opportunity,locations of aneurysms,diameter of aneurysms,Hunt-Hess grading,age,BMI,SBP,DBP,FPG,TG or LDL-C was found between the two groups（ P〈0. 05）. Multivariate Logistic regression analysis results showed that,body temperature equal or over 37. 4 ℃ [OR =1. 623,95% CI（ 1. 118,2. 355） ], Fisher grading [OR = 1. 742,95% CI（ 1. 429,2. 123） ] and ABI [OR = 0. 719,95% CI（ 0. 478,0. 888） ] were influencing factors of DCI in patients with aSAH（ P〈0. 05）. ROC curve showed that,AUC of ABI in predicting DCI was 0. 669 [95% CI（ 0. 544,0. 794） ] in patients with aSAH,the optimum truncation value was0. 965,the sensitivity was 0. 872, the specificity was 0. 429, the Youden index was 0. 301. Conclusion ABI is one of influencing factors of DCI in patients with aSAH,it has certain predictive value in predicting DCI in patients with aSAH.

关 键 词：蛛网膜下腔出血 迟发性脑缺血 踝肱指数 

分 类 号：R743.35[医药卫生—神经病学与精神病学]