眼动脉或视网膜动脉阻塞患者年龄校正Charlson合并症指数与缺血性脑卒中风险的关联性  

Relationship between age-adjusted Charlson comorbidity index and ischemic stroke in patients with ophthalmic artery occlusion or retinal artery occlusion

作　　者：姚裕锋 陈振宇 梁慧娴 王晶[5] 罗天一 宋其缘 钟英 窦晓燕[1] Yao Yufeng;Chen Zhenyu;Liang Huixian;Wang Jing;Luo Tianyi;Song Qiyuan;Zhong Ying;Dou Xiaoyan(Department of Ophthalmology,Shenzhen Second People's Hospital,Shenzhen 518035,China;Shantou University Medical College,Shantou 515031,China;Department of Cardiovascular Medicine,Shenzhen Second People's Hospital,Shenzhen 518035,China;Department of Clinical Medicine,Division of Medicine,Shenzhen University,Shenzhen 518037,China;Department of Ultrasound department,Shenzhen Second People's Hospital,Shenzhen 518035,China)

机构地区：[1]深圳大学第一附属医院、深圳市第二人民医院眼科,深圳518035 [2]汕头大学医学院,汕头515031 [3]深圳大学第一附属医院、深圳市第二人民医院心血管内科,深圳518035 [4]深圳大学医学部临床医学系,深圳518037 [5]深圳大学第一附属医院、深圳市第二人民医院超声科,深圳518035

出　　处：《中华眼底病杂志》2023年第5期387-393,共7页Chinese Journal of Ocular Fundus Diseases

基　　金：深圳市第二人民医院临床研究基金/广东省高水平医院建设项目(20213357016,20233357006)。

摘　　要：目的初步探索眼动脉阻塞(OAO)或视网膜动脉阻塞(RAO)患者年龄校正Charlson合并症指数(aCCI)与缺血性脑卒中发生风险的关联性。方法单中心回顾性队列研究。2004年6月至2020年12月于深圳市第二人民医院眼科检查确诊的OAO或RAO患者74例纳入研究。收集患者临床特征等基线资料,采用aCCI对患者的全身合并症情况进行评分。结局事件为缺血性脑卒中的发生。中位随访时间1796.5d。根据分段Cox回归模型的最大似然比和递归算法确定aCCI拐点值为6,据此将患者分为低aCCI组(<6分)和高aCCI组(≥6分)。采用Cox回归模型量化评估基线aCCI与结局事件的关联性。结果74例患者中,男性53例,女性21例;年龄(55.22±14.18)(19~84)岁。OAO9例,RAO65例。aCCI值为1~10分,中位数3分。其中,低aCCI组和高aCCI组分别为63(85.14%,63/74)、11(14.86%,11/74)例。因2例患者无法确定从基线到发生结局事件的时间,故纳人72例患者进行Cox回归分析;结果显示,未来发生缺血性脑卒中者16例(22.22%,16/72)。低aCCI组基线aCCI与结局事件明显关联[风险比(HR)=1.76,95%可信区间(CI)1.21~2.56,P=0.003],基线aCCI每增加1分,未来缺血性脑卒中发生风险平均升高76%;高aCCI组基线aCCI与结局事件无明显关联(HR=0.66,95%CI0.33~1.33,P=0.247)。结论aCCI评分是OAO或RAO患者重要的预后信息,较高的基线aCCI评分预示较高的缺血性脑卒中发生风险,且其关联性存在饱和效应。Objective To investigate the relationship between age-adjusted Charlson comorbidity index(aCCI)and ischemic stroke in patients with ophthalmic artery occlusion(OAO)or retinal artery occlusion(RAO).Methods A single center retrospective cohort study.Seventy-four patients with OAO or RAO diagnosed by ophthalmology examination in Shenzhen Second People's Hospital from June 2004 to December 2020 were included in the study.The baseline information of patients were collected and aCCI was used to score the patients'comorbidity.The outcome was ischemic stroke.The median duration of follow-up was 1796.5 days.According to the maximum likelihood ratio of the two-piecewise COX regression model and the recursive algorithm,the aCCI inflection point value was determined to be 6,and the patients were divided into low aCCI group(<6 points)and high aCCI group(≥6 points).A Cox regression model was used to quantify the association between baseline aCCI and ischemic stroke.Results Among the 74 patients,53 were males and 21 were females,with the mean age of(55.22±14.18)(19-84)years.There were 9 patients of 0A0 and 65 patients of RAO.The aCCI value ranges from 1 to 10 points,with a median of 3 points.There were 63 patients(85.14%,63/74)in the low aCCI group and 11 patients(14.86%,11/74)in the high aCCI group.Since 2 patients could not determine the time from baseline to the occurrence of outcome events,72 patients were included for Cox regression analysis.The results showed that 16 patients(22.22%,16/72)had ischemic stroke in the future.The baseline aCCI in the low aCCI group was significantly associated with ischemic stroke[hazard ratio(HR)=1.76,95%confidence interval(CD)1.21-2.56,P=0.003],and for every 1 point increase in baseline aCCI,the risk of future ischemic stroke increased by 76%on average.The baseline aCCI in the high aCCI group had no significant correlation with the ischemic stroke(HR=0.66,95%CI 0.33-1.33,P=0.247).Conclusions aCCI score is an important prognostic information for patients with OAO or RAO.A higher baseline

关 键 词：年龄校正Charlson合并症指数 目眼动脉阻塞 视网膜动脉阻塞 脑卒中 

分 类 号：R774.1[医药卫生—眼科] R743.3[医药卫生—临床医学]