全身免疫炎症指数对非瓣膜性房颤患者缺血性脑卒中的预测价值  

Predictive value of systemic immunoinflammatory index for ischemic stroke in patients with nonvalvular atrial fibrillation

作　　者：吴照科[1] 白莹 阿曼古力·瓦衣提 魏明 朱慎慎 胡艳敏 张金盈[3] WU Zhaoke;BAI Ying;Amanguli WAYIT;WEI Ming;ZHU Shenshen;HU Yanmin;ZHANG Jinying(The Second Affiliated Hospital of Zhengzhou University,Zhegnzhou 450003,China;Hami Central Hospital,Hami 839099,China;The First Affiliated Hospital of Zhengzhou University,Zhegnzhou 450052,China)

机构地区：[1]郑州大学第二附属医院,河南郑州450003 [2]哈密市中心医院,新疆哈密839099 [3]郑州大学第一附属医院,河南郑州450052

出　　处：《中国实用神经疾病杂志》2023年第4期453-459,共7页Chinese Journal of Practical Nervous Diseases

基　　金：国家自然科学基金面上项目(编号:81870328;82000238)。

摘　　要：目的 探讨全身免疫炎症指数(SII)对非瓣膜性心房颤动(NVAF)患者发生缺血性脑卒中(IS)的预测价值。方法 选取2020-01—2021-12在郑州大学第二附属医院住院的185例NVAF患者,根据是否合并缺血性脑卒中将患者分为2组:卒中组(91例)和非卒中组(94例),收集2组患者的一般资料、CHA2DS2-VASc评分、实验室指标、超声心动图指标并进行比较。采用Logistic回归分析SII与NVAF患者发生IS的相关性,绘制受试者工作特征(ROC)曲线,评估SII对NVAF患者发生IS风险的预测价值。结果卒中组CHA2DS2-VASc评分、血尿酸、中性粒细胞计数、SII、左心房前后径均高于非卒中组(P<0.05);卒中组阵发性心房颤动患者比例、左心室射血分数低于非卒中组(P<0.05)。多因素回归分析显示,SII是NVAF患者发生IS的独立危险因素(P<0.05)。ROC曲线显示SII预测NVAF患者IS风险的曲线下面积为0.757,最佳截点值为733.12,灵敏度为59%,特异度为85%。结论 SII对NVAF患者发生IS具有一定的预测价值。Objective To investigate value of systemic immune inflammation index(SII) for ischemic stroke in patients with non-valvular atrial fibrillation(NVAF).Methods A total of 185 patients with non-valvular atrial fibrillation admitted to the Second Affiliated Hospital of Zhengzhou University from January 2020 to December 2021 were selected and divided into divided into two groups according to whether they were complicated with ischemic stroke:The stroke group(91 cases)and the non-stroke group(94 cases)were compared.General data,CHA2DS2-VASc score,laboratory indexes and echocardiogram indexes of the two groups were collected and compared.Logistic regression was used to analyze the correlation between systemic immune inflammation index and ischemic stroke in patients with nonvalvular atrial fibrillation,and receiver operating characteristics(ROC)curve was drawn to evaluate the predictive value of systemic immune inflammation index on the risk of ischemic stroke in patients with nonvalvular atrial fibrillation.Results The CHA2DS2-VASc score,blood uric acid,neutrophil count,systemic immunoinflammatory index,left atrium anteriorposterior diameter in stroke group were higher than those in non-stroke group(P<0.05).The proportion of paroxysmal atrial fibrillation and left ventricular ejection fraction in stroke group were lower than those in non-stroke group(P<0.05).Multifactor regression analysis showed that systemic immunoinflammatory index was an independent risk factor for ischemic stroke in patients with nonvalvular atrial fibrillation(P<0.05).ROC curve showed that the area under the curve of SII in predicting the IS risk of NVAF patients was 0.757,the optimal cut-off value was 733.12,the sensitivity was 59%,the specificity was 85%.Conclusion Systemic immune inflammatory index has certain predictive value for ischemic stroke in patients with non-valvular atrial fibrillation.

关 键 词：缺血性脑卒中 全身免疫炎症指数 非瓣膜性心房颤动 炎症反应 预测 

分 类 号：R743.33[医药卫生—神经病学与精神病学]