肌酸激酶指数对急性缺血性脑卒中患者复发风险的影响  

The effect of CK-MB/CK ratio on the recurrence of acute ischemic stroke

作　　者：谢宇颖[1] 马雪松[1] 刘星彤 戚思华[1] Xie Yu-ying;Ma Xue-song;Liu Xing-tong;Qi Si-hua(Department of Anesthesiology,the Fourth Affiliated Hospital of Harbin Medical University,Harbin 150001,China)

机构地区：[1]哈尔滨医科大学附属第四医院麻醉科,黑龙江哈尔滨150001

出　　处：《中国急救医学》2021年第8期714-717,共4页Chinese Journal of Critical Care Medicine

基　　金：黑龙江省博士后科研启动基金(LBH-Q20155)。

摘　　要：目的探讨急性缺血性脑卒中患者肌酸激酶(CK)指数与其他危险因素对其复发的影响。方法分析哈尔滨医科大学附属第四医院神经内外科自2017年1月至2017年12月收治的1038例急性缺血性脑卒中患者的基线资料,肌酸激酶-同工酶(CK-MB)/CK称为CK指数。根据CK指数是否> 15%分为两组,CK指数≤15%组581例,CK指数> 15%组457例。根据Kaplan-Meier生存分析比较不同危险因素急性缺血性脑卒中复发率的差异,通过单因素与多因素Cox回归模型,分析影响急性缺血性脑卒中复发的独立危险因素及危险因素之间的交互作用。结果 Kaplan-Meier生存分析显示,CK指数> 15%组急性缺血性脑卒中复发率为36.5%,明显高于CK指数≤15%组(20.3%),两组的生存曲线差异有统计学意义(P <0.0001)。Cox逐步回归分析结果显示,CK指数、性别、吸烟、饮酒及糖尿病均为急性缺血性脑卒中复发的影响因素。结论 CK指数升高是急性缺血性脑卒中复发的危险因素。CK指数升高、性别、吸烟、饮酒及糖尿病都会影响急性缺血性脑卒中的复发。Objective To evaluate the effects of CK-MB/CK ratio on the recurrence of stroke in the patients with acute ischemic stroke. Methods 1038 patients with acute ischemic stroke admitted to the Department of Neurology and Neurosurgery of the Fourth Affiliated Hospital of Harbin Medical University from January 2017 to December 2017 were analyzed retrospectively. Participants were divided in CK-MB/CK≤15% group( 581 cases) and CK-MB/CK > 15% group( 457 cases). Kaplan-Meier survival analysis was used to compare the differences in stroke recurrence rates of different risk factors,single-factor and multivariate Cox regression models were used to analyze independent risk factors that affect stroke recurrence,and the interaction between risk factors. Results Kaplan-Meier survival analysis showed that the stroke recurrence rate in CK-MB/CK > 15% group was 36. 5%,which was significantly higher than that in the CK-MB/CK≤15% group( 20. 3%). The difference in survival curves between the two groups was statistically significant( P < 0. 0001). Cox stepwise regression analysis results show that CK-MB/CK ratio,gender,smoking history,drinking history,diabetes history were all influencing factors for the recurrence. Conclusions Elevated CK-MB/CK ratio increases the recurrence of acute ischemic stroke patients. CK-MB/CK ratio,gender,smoking history,drinking history,and diabetes history will affect the recurrence of stroke.

关 键 词：脑卒中 缺血 肌酸激酶(CK) 肌酸激酶-同工酶(CK-MB) 肌酸激酶指数(CK-MB/CK) 复发 

分 类 号：R743.3[医药卫生—神经病学与精神病学]