老年脑血管病介入治疗患者的预后影响因素分析  

Analysis of Prognostic Factors in Elderly Patients with Cerebrovascular Disease Undergoing Interventional Therapy

作　　者：曾维斌 陈日玉 张月 廖婵彤 蔡仁端[2] Zeng Weibin;Chen Riyu;Zhang Yue;Liao Chantong;Cai Renduan(Department of Radiology Referral Room,Hainan General Hospital,Hainan Hainan Affiliated Hospital of Hainan Medical University,Haikou 570311;Department of Neurosurgery,Hainan General Hospital,Hainan Affiliated Hospital of Hainan Medical University,Haikou 570311)

机构地区：[1]海南省人民医院海南医学院附属海南医院放射科介入室,海口570311 [2]海南省人民医院海南医学院附属海南医院神经外科,海口570311

出　　处：《国际老年医学杂志》2023年第6期656-660,共5页International Journal of Geriatrics

基　　金：海南省临床医学中心建设项目资助(琼卫医函[2021]276号);海南省卫生健康行业科研项目(22A200021)。

摘　　要：目的探究老年脑血管病患者原发病特征、介入治疗后炎症指标及神经功能相关指标的差异,旨在为其预后判断提供依据。方法选取2020年1月~2022年12月于海南省人民医院接受介入治疗的120例老年脑血管病患者临床资料进行回顾性分析,根据患者预后划分为预后良好组(93例)与预后不良组(27例)。观察并比较两组患者一般临床资料[年龄、性别、体质量指数、原发病类型、是否患高血压、饮酒情况、吸烟情况、入院前病程]、介入治疗后炎症指标[中性粒细胞与淋巴细胞比值(NLR)、C反应蛋白(CRP)、淋巴细胞与单核细胞比值(LMR)]及神经功能相关指标[格拉斯哥预后量表(GOS)评分、美国国立卫生研究院脑卒中量表(NIHSS)评分、日常生活活动能力(ADL)评分及改良Rankin量表(mRS)评分]。通过多因素logistic回归分析筛选介入术后老年脑血管病患者预后不良的独立危险因素,通过ROC曲线分析各因素对患者预后不良的独立预测价值。结果预后不良组高血压患病率、吸烟比例、平均NLR、CRP水平及NIHSS评分均显著高于预后良好组,而平均ADL评分显著低于预后良好组(P<0.05),其他指标组间比较差异均无统计学意义(P>0.05)。多因素logistic回归分析表明,NLR、CRP水平及NIHSS评分是影响老年脑血管病患者介入术后预后的独立危险因素(P<0.05),ADL评分是影响预后的独立保护因素(P<0.05)。ROC分析发现,NLR、CRP水平及NIHSS评分、ADL评分对患者预后不良均具有预测价值(P<0.05)。结论接受介入治疗的老年脑血管病患者原发病特征与预后无明显相关性,但术后炎症指标水平较高、神经功能较差的患者往往预后较差。Objective To investigate the differences of primary disease characteristics,inflammatory parameters and neurological related parameters after interventional therapy in elderly patients with cerebrovascular disease,in order to provide the basis for its prognosis.Methods The clinical data of 120 elderly patients with cerebrovascular disease who received interventional therapy in Hainan Provincial People's Hospital from January 2020 to December 2022 were retrospectively analyzed and divided into good prognosis group(93 cases)and poor prognosis group(27 cases)according to the prognosis of the patients.The general clinical data[age,sex,body mass index,type of primary disease,hypertension,alcohol consumption,smoking status,course of disease before admission],inflammatory parameters[neutrophil to lymphocyte ratio(NLR),C-reactive protein(CRP),lymphocyte to monocyte ratio(LMR)]after interventional therapy and neurological related parameters[Glasgow Outcome Scale(GOS)score,National Institutes of Health Stroke Scale(NIHSS)score,activities of daily living(ADL)score and modified Rankin Scale(mRS)score]were observed and compared between the two groups.The independent risk factors of poor prognosis in elderly patients with cerebrovascular disease after interventional therapy were screened by multivariate logistic regression analysis,and the independent predictive value of each factor for poor prognosis was analyzed by ROC curve.Results The prevalence of hypertension,smoking ratio,mean NLR,CRP level and NIHSS score in the poor prognosis group were significantly higher than those in the good prognosis group,while the mean ADL score was significantly lower than that in the good prognosis group(P0.05).There was no statistically siynificant difference in comparison between two groups on onther indicators(P0.05).Multivariate logistic regression analysis showed that NLR,CRP and NIHSS scores were independent risk factors for the prognosis of elderly patients with cerebrovascular disease after interventional therapy(P0.05),and ADL score

关 键 词：脑血管病 介入治疗 炎症 神经功能 

分 类 号：R743[医药卫生—神经病学与精神病学]