入院血糖与纤维蛋白原比值联合平均动脉压与急性出血性脑卒中患者预后的相关性分析  

Correlation between admission glucose and fibrinogen ratio combined with mean arterial pressure and prognosis of patients with acute haemorrhagic stroke

作　　者：杨凤 何怡瑾 曹佳 YANG Feng;HE Yijin;CAO Jia(Department of Emergency,Hubei Third People's Hospital,Hubei Province,Wuhan 430000,China)

机构地区：[1]湖北省第三人民医院急诊科,湖北武汉430000

出　　处：《中国当代医药》2025年第4期60-65,共6页China Modern Medicine

摘　　要：目的探讨入院血糖与纤维蛋白原比值(AGFR)和平均动脉压(MAP)的指标对急性出血性脑卒中患者预后的影响。方法回顾性分析2020年5月至2023年5月湖北省第三人民医院145例急性出血性脑卒中患者的临床资料,根据预后分为好转组(111例)与未愈组(34例)。比较两组患者一般资料,分析不同数值的AGFR的疾病好转率占比情况,探究AGFR、MAP和联合预测模型与出血性脑卒中患者临床预后之间的影响关系。结果AGFR<1的患者好转率为84.5%,AGFR>1的患者好转率为31.8%。好转组与未愈组吸烟史、高血压史、冠心病史、并发症、血钠、AGFR、MAP、血小板、格拉斯哥昏迷评分(GCS)比较,差异有统计学意义(P<0.05)。logistic多元回归分析显示AGFR、MAP(β=1.699,OR=5.466,95%CI:1.789~16.701)、GCS评分(β=-0.159,OR=0.853,95%CI:0.744~0.978)、血小板(β=-0.010,OR=0.990,95%CI:0.982~0.999)、吸烟史(β=-1.222,OR=0.295,95%CI:0.088~0.991)和冠心病史(β=-1.619,OR=0.198,95%CI:0.054~0.721)是急性出血性脑卒中患者预后不良的独立危险因素(P<0.05)。受试者工作特征(ROC)分析显示联合预测的AUC为0.7815,95%CI:0.730~0.834(P<0.05),约登指数为0.445,敏感度为60.4%,特异度为84.0%。决策曲线分析(DCA)显示,联合预测模型在风险阈值为0.28~0.39时具有较高的临床预测价值。结论AGFR、MAP对急性出血性脑卒中患者预后均有非常明显的预测作用,其中MAP和AGFR联合预测模型对急性出血性卒中患者的病情恶化有较高的预判能力。GCS评分、血小板含量、吸烟史以及冠心病史因素为出血性脑卒中预后提供额外的危险分成信息。Objective To investigate the effect of admission glucose and fibrinogen ratio(AGFR)and mean arterial pressure(MAP)on prognosis of patients with acute hemorrhagic stroke.Methods The clinical data of 145 patients with acute hemorrhagic stroke in the Hubei third People's Hospital from May 2020 to May 2023 were retrospectively analyzed.According to the prognosis,111 patients were divided into the improved group and 34 patients were non-cured groupe.The general data of the two groups of patients were compared,the proportion of disease improvement rate of AGFR with different values was analyzed,and the relationship between AGFR,MAP and combined prediction model and clinical prognosis of patients with hemorrhagic stroke was explored.Results Patients with AGFR<1 had a recovery rate of 84.5%and those with AGFR>1 had a recovery rate of 31.8%.There were significant differences in smoking history,hypertension history,coronary heart disease history,complications,blood sodium,AGFR,MAP,platelet,Glasgow coma score(GCS)between the improved group and the non-cured group(P<0.05).Logistic multiple regression analysis showed that AGFR,MAP(β=1.699,OR=5.466,95%CI:1.789-16.701),GCS scores(β=-0.159,OR=0.853,95%CI:0.744-0.978),platelet(β=-0.010,OR=0.990,95%CI:0.982-0.999),smoking history(β=-1.222,OR=0.295,95%CI:0.088-0.991)and history of coronary heart disease(β=-1.619,OR=0.198,95%CI:0.054-0.721)were independent risk factors for poor prognosis in patients with acute hemorrhagic stroke(P<0.05).Receiver operating characteristic(ROC)analysis showed that the combined prediction AUC was 0.7815,95%CI:0.730-0.834(P<0.05),Yoden index was 0.445,sensitivity was 60.4%,and specificity was 84.0%.Decision curve analysis(DCA)showed that the combined prediction model had high clinical predictive value when the risk threshold was 0.28-0.39.Conclusion The AGFR can predict the prognosis of patients with acute hemorrhagic stroke.The combined prediction model of MAP and AGFR can predict the deterioration of acute hemorrhagic stroke patients.Factors such

关 键 词：出血性脑卒中 入院血糖与纤维蛋白原比值 平均动脉压 危险因素 预后 

分 类 号：R743.34[医药卫生—神经病学与精神病学]