SCI、SIRI、SII及β2-MG在缺血性脑卒中后认知功能障碍中的应用价值  

Application value of SCI,SIRI,SII andβ2-MG in patients with cognitive impairment after ischemic stroke

作　　者：陈志 葛晗明 张格娟 常明则 CHEN Zhi;GE Hanming;ZHANG Gejuan;CHANG Mingze(Department of Neurology,Xi′an Third Hospital,Xi′an,Shaanxi 710000,China)

机构地区：[1]陕西省西安市第三医院神经内科,陕西西安710000

出　　处：《检验医学与临床》2024年第24期3626-3630,3636,共6页Laboratory Medicine and Clinic

基　　金：陕西省重点研发计划项目(2020ZDLSF04-03);陕西省西安市重大科技计划项目(201805104YX12SF38)。

摘　　要：目的探讨凝血-炎症指数(SCI)、全系统炎症反应指数(SIRI)、系统性免疫炎症指数(SII)、β2-微球蛋白(β2-MG)对缺血性脑卒中后认知功能障碍(iPSCI)的影响及预测价值。方法选取2021年1月至2023年2月该院收治的缺血性脑卒中(IS)患者509例为研究对象,根据简易精神状态量表(MMSE)评分、蒙特利尔认知评估量表(MoCA)评分对IS患者认知功能的评测结果,将患者分为认知正常组和认知障碍组。比较两组基线资料、SCI、SIRI、SII、β2-MG水平,采用受试者工作特征(ROC)曲线评估SCI、SII、SIRI、β2-MG水平预测iPSCI的价值。采用多因素Logistic回归分析iPSCI的影响因素。采用双变量Pearson相关分析iPSCI患者各项指标之间的相关性。结果认知正常组331例,认知障碍组178例。认知障碍组合并高血压、合并糖尿病、合并高脂血症、有吸烟史比例明显高于认知正常组,差异均有统计学意义(P<0.05)。认知障碍组淋巴细胞计数(LYM)低于认知正常组,中性粒细胞计数(NEUT)、血小板计数(PLT)、单核细胞计数(MONO)、白细胞计数(WBC)、纤维蛋白原(Fib)、SCI、SIRI、SII高于认知正常组,血清β2-MG水平低于认知正常组,差异均有统计学意义(P<0.05)。SCI、SIRI、SII及血清β2-MG联合检测预测iPSCI的AUC为0.946,明显大于单项检测的AUC(P<0.05)。多因素Logistic回归分析结果显示,合并高血压、合并糖尿病、合并高脂血症、有吸烟史、SCI升高、SIRI升高、SII升高均是iPSCI的危险因素(P<0.05),血清β2-MG水平升高是iPSCI的保护影响因素(P<0.05)。iPSCI患者SCI、SIRI、SII、血清β2-MG与末次MMSE评分、末次MoCA评分存在相关性(P<0.05);SCI、SIRI与SII呈正相关(r=0.228、0.752,P<0.05),SCI、SIRI、SII与血清β2-MG呈负相关(r=-0.072、-0.296、-0.290,P<0.05)。结论SCI、SIRI、SII、β2-MG联合检测预测iPSCI的价值优于单项指标检测。另外,合并高血压、合并糖尿病、合并高脂血症、有吸�Objective To explore the effect and predictive value of coagulation inflammatory index(SCI),systemic inflammatory response index(SIRI),systemic immune inflammatory index(SII),β2-microglobulin(β2-MG)in patients with cognitive impairment after ischemic stroke(iPSCI).Methods A total of 509 patients with ischemic stroke(IS)admitted to Xi′an Third Hospital from January 2021 to February 2023 were selected as objects.Based on the evaluation results of the Mini Mental State Examination(MMSE)score and the Montreal Cognitive Assessment Scale(MoCA)score,the patients were divided as the cognitive normal group and the cognitive impairment group.Compare the baseline data,SCI,SIRI,SII andβ2-MG level in the two groups,and evaluate the predictive value of SCI,SII,SIRI andβ2-MG level for iPSCI using receiver operating characteristic(ROC)curve.Multivariate Logistic regression analysis was used to identify the influencing factors of iPSCI.Pearson correlation analysis was used to examine the correlations between various indicators.Results There are 331 cases in the cognitve normal group,178 cases in the impairment group.The proportions of hypertension,diabetes,hyperlipidemia and smoking history in the cognitive impairment group were significantly higher than those in the cognitive normal group(P<0.05).The lymphocyte count(LYM)in the cognitive impairment group was lower than that in the cognitive normal group,while the neutrophil count(NEUT),platelet count(PLT),monocyte count(MONO),white blood cell count(WBC),fibrinogen(Fib),SCI,SIRI and SII were higher than those in the cognitive normal group(P<0.05).The serumβ2-MG was lower than that in the cognitive normal group(P<0.05).The AUC of the combined detection of SCI,SIRI,SII and serumβ2-MG for predicting iPSCI was 0.946,which was significantly bigger than the AUC of single detection(P<0.05).Multivariate Logistic regression analysis showed that hypertension,diabetes,hyperlipidemia,smoking history,increased SCI,SIRI,SII were all independent risk factors of iPSCI,and increased serum

关 键 词：缺血性脑卒中 认知障碍 凝血-炎症指数 全系统炎症反应指数 系统性免疫炎症指数 Β2-微球蛋白 

分 类 号：R446.9[医药卫生—诊断学] R743[医药卫生—临床医学]