脑利钠肽、超敏C反应蛋白、纤维蛋白原与急性脑梗死患者NIHSS评分关系及支架介入成形术预后预测效能探究  

Relationship between brain natriuretic peptide,hypersensitivity protein,fibrinogen and NIHSS score of cerebral infarction patients and prognostic efficacy of stent interventional plastic surgery

作　　者：黄家建 黄渊智[1] 农金尧 Huang Jiajian;Huang Yuanzhi;Nong Jinyao(Department of Neurology,the Second People's Hospital of Qinzhou,Guangxi,Guangxi 535000,China)

机构地区：[1]广西钦州市第二人民医院神经内科,广西535000 [2]广西右江民族医学院附属医院神经内科

出　　处：《脑与神经疾病杂志》2024年第12期740-745,共6页Journal of Brain and Nervous Diseases

基　　金：2021年度百色市科学研究与技术开发计划([2021]11号-14)。

摘　　要：目的分析脑利钠肽(BNP)、超敏C反应蛋白(hs-CRP)、纤维蛋白原(FIB)与急性脑梗死(ACI)患者神经功能缺损评分(NIHSS)关系及对支架介入成形术预后预测效能。方法选择2020年3月至2022年3月于广西钦州市第二人民医院神经内科接受支架介入成形术的120例ACI患者作为研究对象,检测手术前后BNP、hs-CRP、FIB水平及NIHSS评分。出院后进行3个月的随访,根据改良Rankin量表评分分为预后良好组(Rankin评分≤2分)与预后不良组(Rankin评分≥3分),对比两组术前基础资料与BNP、hs-CRP、FIB水平及NIHSS评分,建立Logistic回归模型分析支架介入成形术预后的影响因素;经Pearson相关性检验BNP、hs-CRP、FIB水平与NIHSS评分的关系;绘制ROC曲线分析BNP、hs-CRP、FIB水平对预后的预测价值。结果手术后ACI患者的血清BNP、hs-CRP、FIB水平及NIHSS评分均比手术前降低(P<0.05);术后随访1个月的改良Rankin量表评分显示,120例患者预后良好的有82例(68.33%),预后不良的有38例(31.67%);预后良好组、预后不良组性别、年龄、病程、饮酒史、吸烟史、高血压病史、冠心病史、糖尿病史相比,差异无统计学意义(~均P>0.05);预后不良组BNP、hs-CRP、FIB水平及NIHSS评分均较预后良好组高(~均P<0.05);二元Logistic回归分析结果显示,BNP、hs-CRP、FIB水平、NIHSS评分均是ACI患者支架介入成形术预后的危险因素(OR>1,P<0.05);绘制ROC曲线发现,BNP、hs-CRP、FIB水平及联合预测支架介入成形术预后的AUC为0.807(95%CI:0.730~0.884)、0.797(95%CI:0.701~0.892)、0.821(95%CI:0.746~0.896)、0.887(95%CI:0.827~0.948)。结论BNP、hs-CRP、FIB水平与ACI患者神经缺损程度呈正相关,且通过联合检测可提高支架介入成形术预后的预测效能,临床应监测上述指标以制定相关方案改善患者预后。Objective To analyze the relationship between brain natriuretic peptide(BNP),hypersensitivity protein(hs-CRP),fibrinogen(FIB)and neurological deficit score(NIHSS)in patients with acute cerebral infarction(ACI)and its predictive efficacy for the prognosis of stenting angioplasty.Methods A total of 120 patients with ACI who were going to receive stent angioplasty in our hospital from March 2020 to March 2022 were selected as the research subjects.The levels of BNP,hs-CRP,FIB and NIHSS scores before and after the operation were measured.After discharge,they were followed-up for three months and divided into a good prognosis group(Rankin score≤2)and a poor prognosis group(Rankin score≥3)according to the modified Rankin scale score.The basic preoperative data of the two groups were compared with BNP,hs-CRP,FIB levels and NIHSS score,and a Logistic regression model was established to analyze the influencing factors of prognosis in stent angioplasty.The relationship between the levels of BNP,hs-CRP,and FIB and NIHSS score was tested by Pearson correlation.ROC curve was drawn to analyze the prognostic value of BNP,hs-CRP and FIB levels.Results The levels of serum BNP,hs-CRP,FIB and NIHSS of patients with ACI after operation were lower than those before operation(P<0.05).The modified Rankin scale score obtained after one-month follow-up showed that among the 120 patients,82 cases(68.33%)had a good prognosis,and38 cases(31.67%)had a poor prognosis.The differences of good prognosis and non-group prognosis in sex,age,disease course,drinking history,smoking history,hypertension history,coronary heart disease history and diabetes history were not statistically significant(P>0.05).The levels of BNP,hs-CRP,FIB and NIHSS in the poor prognosis group were higher than those in the good prognosis group(P<0.05).The results of binary logistic regression analysis showed that BNP,hs-CRP,FIB and NIHSS scores were all risk factors for the prognosis of stent angioplasty in patients with cerebral infarction(OR>1,P<0.05).Plotting the ROC

关 键 词：急性脑梗死 支架介入成形术 脑利钠肽 超敏C反应蛋白 纤维蛋白原 NIHSS评分 预后 

分 类 号：R743.32[医药卫生—神经病学与精神病学]