红细胞分布宽度对静脉溶栓患者预后的评估价值  

Correlation of red cell distribution width with prognosis in patients with intravenous thrombolysis

作　　者：张鑫 于敏[1] ZHANG Xin;YU Min(Department of Neurology,the Third People's Hospital of Dalian,Dalian 116000,China)

机构地区：[1]大连市第三人民医院神经内科,辽宁大连116000

出　　处：《大连医科大学学报》2024年第6期503-507,513,共6页Journal of Dalian Medical University

基　　金：大连市医学科学研究计划项目(2011011)。

摘　　要：目的探究红细胞分布宽度(RDW)水平对急性缺血性脑卒中(AIS)患者行重组组织型纤溶酶原激活剂(rt-PA)静脉溶栓后3个月的预后评估价值。方法收集2020年12月至2023年1月于大连市第三人民医院卒中绿色通道接受rt-PA静脉溶栓治疗的符合入排标准的AIS患者共100例。记录患者一般资料、实验室指标及不同时间节点的临床评分。根据患者3个月时的改良Rankin量表(mRs)评分,分为预后良好组58例和预后不良组42例。比较两组间年龄、性别、既往史、基线血压、RDW、血糖、血脂等化验指标及基线NIHSS评分和mRs评分的差异。通过Logistic回归模型分析AIS 3个月预后不良的独立危险因素,并采用受试者工作特征(ROC)曲线分析RDW对患者预后不良的预测价值。结果预后不良组患者较预后良好组年龄更大,RDW值、基线NIHSS评分和mRs评分更高,差异均有统计学意义(P<0.05)。Logistic二元回归分析显示,RDW值(OR=2.819,95%CI 1.195~6.651,P=0.018)和入院mRs评分(OR=3.013,95%CI 1.576~5.763,P=0.001)为AIS预后不良的独立影响因素。ROC曲线分析显示,RDW预测3个月预后的敏感性、特异性和AUC分别为48.3%、85.7%和0.701,最佳截断值为12.55%。结论RDW是AIS静脉溶栓患者3个月预后不良的影响因素,对预后具有一定预测价值。Objective To investigate the prognostic value of red cell distribution width(RDW)for assessing the 3-month prognosis of patients with acute ischemic stroke(AIS)following recombinant tissue plasminogen activator(rt-PA)intravenous thrombolysis treatment.Methods A total of 100 AIS patients,who met the admission criteria and received rt-PA intravenous thrombolysis therapy at the stroke center of the Third People's Hospital of Dalian from December 2020 to January 2023,were enrolled in this study.Clinical data,including general data,laboratory indicators,NIHSS scores,and modified Rankin scale(mRs)scores at different time points,were collected.Based on the 3-month mRs scores,the patients were divided into favorable prognosis group(58 cases)and poor prognosis group(42 cases).Differences in age,sex,past medical history,baseline blood pressure,RDW,blood glucose,blood lipids and other laboratory indicators,as well as baseline NIHSS scores and mRs scores were compared between the two groups.Independent risk factors for poor prognosis of AIS patients at 3 months were analyzed by logistic regression model,and the predictive value of RDW for poor prognosis was assessed using a receiver operating characteristic(ROC)curve.Results Significant differences were observed between the favorable and poor prognosis groups in terms of age,RDW,baseline NIHSS scores and mRs scores(P<0.05).The patients in the poor prognosis group were older,had higher RDW values,and higher baseline NIHSS scores and mRs scores.Logistic regression analysis revealed that RDW(OR=2.819,95%CI 1.195-6.651,P=0.018)and baseline mRs score(OR=3.013,95%CI 1.576-5.763,P=0.001)were independent risk factors for poor prognosis.ROC curve analysis showed that the sensitivity,specificity and area under the curve(AUC)of RDW for predicting the final outcome were 48.3%,85.7%and 0.701,respectively,with an optimal cut-off value of 12.55%.Conclusion RDW is an independent risk factor for poor prognosis in AIS patients thrombolysis undergoing rt-PA intravenous thrombolysis treatment.H

关 键 词：红细胞分布宽度 急性缺血性脑卒中 静脉溶栓 预后 

分 类 号：R741[医药卫生—神经病学与精神病学]