TPO-Ab、FT3/FT4比值、TBiL水平与急性缺血性脑卒中患者短期预后的关系研究  

The relationship between TPO-Ab, FT3 FT4 ratio, TBiL level and short-term prognosis in patientswith acute ischemic stroke

作　　者：孙娟 韦玉[2] 刘赟煜 Sun Juan;Wei Yu;Liu Yunyu(Department of Clinical Laboratory,the First People′s Hospital of Mengcheng County,Bozhou 233500,China)

机构地区：[1]蒙城县第一人民医院检验科,亳州233500 [2]安徽医科大学第二附属医院检验科

出　　处：《中华保健医学杂志》2024年第3期309-312,共4页Chinese Journal of Health Care and Medicine

基　　金：安徽省高校自然科学基金研究项目(KJ2021ZD0029)。

摘　　要：目的 探究甲状腺过氧化物酶抗体(thyroid peroxidase antibodies, TPO-Ab)、游离三碘甲状腺原氨酸(free triiodothyronine, FT3)和游离甲状腺素(free thyroxine, FT4)的比值(FT3/FT4)、血清总胆红素(total bilirubin, TBiL)水平与急性缺血性脑卒中(acute ischemic stroke, AIS)患者短期预后的关系。方法 回顾性选取2021年3月~2023年5月在蒙城县第一人民医院接受治疗的124例急性缺血性脑卒中患者,治疗3个月后根据改良Rankin量表(modified rankin scale, mRS)评分分为良好预后组(82例)和预后不良组(42例)。使用单因素及多因素logistic回归分析TPO-Ab、FT3/FT4比值、TBiL水平及其他相关因素对急性缺血性脑卒中患者短期预后的影响,并且构建患者不良预后预测模型,模型准确度以ROC曲线判断。结果 多因素分析结果显示,两组患者年龄(OR=2.045,95%CI=1.159~3.608,P=0.014)、美国卫生研究院卒中量表(NIHSS)(OR=1.805,95%CI=1.058~3.079,P=0.030)、TBiL(OR=0.620,95%CI=0.418~0.922,P=0.018)、FT3/FT4(OR=0.244,95%CI=0.088~0.679,P=0.007)、TPO-Ab(OR=3.242,95%CI=1.312~8.009,P=0.011)均为患者预后不良的独立影响因素(P<0.05)。在此基础上建立风险预测模型,模型公式:Logit(P)=-42.915+0.715×年龄+0.591×NIHSS-0.477×TBiL-1.409×FT3/FT4+1.176×TPO-Ab。其ROC曲线下面积为0.996,95%CI=0.991~1.000-,敏感度为1.000,特异度为0.963,Youden指数为0.963。结论 TPO-Ab、FT3/FT4比值、TBiL水平均为急性缺血性脑卒中患者短期预后不良的独立影响因素,在此基础上建立的联合预测模型预测效能良好。Objective To explore the relationship between thyroid peroxidase antibody(TPO-Ab),free triiodothyronine(FT3)and free thyroxine(FT4)ratio(FT3 FT4),serum total bilirubin(TBiL)level and short-term prognosis of patients with acute ischemic stroke(AIS).Methods A total of 124 patients with acute ischemic stroke who were treated in the hospital from March 2021 to May 2023 were retrospectively selected as the research objects.According to the modified Rankin Scale(mRS)score after 3 months of treatment,they were divided into good prognosis group and poor prognosis group.Univariate and multivariate logistic regression analysis were used to analyze the effects of Tpo-ab,FT3 FT4 ratio,TBiL level and other related factors on the short-term prognosis of patients with acute ischemic stroke,and the prediction model of poor prognosis of patients was constructed.The accuracy of the model was judged by ROC curve.Results There were 82 cases(66.13%)in the good prognosis group and 42 cases(33.87%)in the poor prognosis group.The age(OR=2.045,95%CI=1.159~3.608,P=0.014),NIHSS(OR=1.805,95%CI=1.058~3.079,P=0.030),TBiL(OR=0.620,95%CI=0.418~0.922,P=0.018),FT3 FT4(OR=0.244,95%CI=0.088~0.679,P=0.007),TPO-Ab(OR=3.242,95%CI=1.312~8.009,P=0.011)of the two groups were independent influencing factors of poor prognosis(P<0.05).On this basis,a risk prediction model was established.The model formula was Logit(P)=-42.915+0.715×age+0.591×NIHSS-0.477×TBiL-1.409×FT3 FT4+1.176×TPO-Ab.The area under the ROC curve was 0.996,95%CI=0.991~1.000,the sensitivity was 1.000,the specificity was 0.963,and the Youden index was 0.963.Conclusion TPO-Ab,FT3 FT4 ratio and TBiL level were all independent influencing factors of short-term poor prognosis in patients with acute ischemic stroke,and the combined prediction model established on this basis had good prediction To explore the relationship between thyroid peroxidase antibody(TPO-Ab),free triiodothyronine(FT3),free thyroxine(FT4)ratio(FT3 FT4),serum total bilirubin(TBiL)level and the short-term prognosis of pati

关 键 词：甲状腺过氧化物酶抗体 游离三碘甲腺原氨酸/游离甲状腺素比值 血清总胆红素 急性缺血性脑卒中 短期预后 

分 类 号：R743[医药卫生—神经病学与精神病学]