血清神经元特异烯醇化酶结合心电图缺血性ST-T变化对老年急性脑梗死病情严重程度及预后的评估  

Evaluation of the severity and prognosis of acute cerebral infarction in elderly patients with serum neuron-specific enolase combined with electrocardiogram ischemic ST-T changes

作　　者：仲雪娇 吕新云 ZHONG Xuejiao;LÜXinyun(Department of Cardiac Function,Nanjing Tongren Hospital,Nanjing 211000,Jian-gsu,China;Department of Neurology,Nanjing Tongren Hospital,Nanjing 211000,Jian-gsu,China)

机构地区：[1]南京同仁医院心功能室,南京211000 [2]南京同仁医院神经内科,南京211000

出　　处：《医学研究与战创伤救治》2025年第3期285-289,共5页Journal of Medical Research & Combat Trauma Care

摘　　要：目的探究血清神经元特异烯醇化酶(NSE)结合心电图缺血性ST-T变化评估老年急性脑梗死(ACI)病情严重程度及预后的意义。方法选取2022年1月至2024年1月于南京同仁医院接受治疗的80例老年ACI患者。依据病情分为严重组(NIHSS评分>10分,n=28)、中度组(NIHSS评分5~10分,n=30)、轻度组(NIHSS评分<5,n=21);根据疾病预后情况分为预后不良组(n=68)、预后良好组(n=12)。对比不同严重程度及预后间血清NSE水平和心电图缺血性ST-T变化情况,分析血清NSE水平与严重程度及预后的相关性,Logistic回归分别分析ACI患者病情严重程度、预后不良的相关因素,ROC分析血清NSE结合心电图缺血性ST-T改变评估老年ACI严重程度及预后的价值。结果严重组血清NSE水平[(15.53±3.84)ng/L]较中度组、轻度组[(26.26±6.53)、(41.35±8.42)ng/L]明显降低(P<0.05);轻度组较中度组明显升高(P<0.05)。严重组无ST-T变化占比显著高于中度组、轻度组;中度组短暂性ST-T变化占比显著高于严重组、轻度组;轻度组持续性ST-T变化占比高于严重组、中度组(P<0.05)。预后不良组NSE水平显著高于预后良好组(P<0.05)。预后不良组持续性ST-T变化占比显著低于预后良好组,无ST-T变化占比显著高于预后良好组(P<0.05)。Logistic回归分析显示,血清NSE水平、心电图缺血性ST-T改变是导致ACI患者病情严重及预后不良的相关因素(P<0.05)。ROC曲线显示,血清NSE、心电图缺血性ST-T改变评估老年ACI严重程度的AUC分别为0.845、0.805,两者联合的AUC为0.924;血清NSE、心电图缺血性ST-T改变评估患者不良预后的AUC分别为0.852、0.834,两者联合的AUC为0.981。结论血清NSE水平结合心电图缺血性ST-T变化有利于老年ACI患者病情判断和预后评估,可作为临床治疗以及预后提供参考。Objective To explore the significance of serum neuron specific enolase(NSE)combined with electrocardiogram ischemic ST-T changes in evaluating the severity and prognosis of acute cerebral infarction(ACI)in elderly patients.Methods 80 elderly ACI patients who received treatment at Nanjing Tongren Hospital from January 2022 to January 2024 were selected.According to the severity of the condition,it is divided into the severe group(NIHSS score>15 points,n=28),moderate group(NIHSS score 5~10,n=30),mild group(NIHSS score<5,n=21);According to the prognosis of the disease,it is divided into a poor prognosis group(n=68)and a good prognosis group(n=12).The changes of serum NSE level and electrocardiogram ischemic ST-T in patients with different severity and prognosis were compared,and the correlation between serum NSE level and severity and prognosis was analyzed.The factors related to severity and poor prognosis of ACI pa-tients were analyzed by Logistic regression.ROC analysis of serum NSE combined with ECG ischemic ST-T changes in the assessment of ACI severity and prognosis in elderly patients.Results The serum NSE level in the severe group[(15.53±3.84)ng/L]was significantly lower than that in the moderate and mild groups[(26.26±6.53,41.35±8.42)ng/L](P<0.05);The mild group showed a significant increase compared to the moderate group(P<0.05).The proportion of severe group without ST-T changes was significantly higher than that of moderate group and mild group;The propor-tion of transient ST-T changes in the moderate group was significantly higher than that in the severe and mild groups;The proportion of persistent ST-T changes in the mild group was higher than that in the severe and moderate groups(P<0.05).The NSE level in the poor prognosis group was significantly higher than that in the good prognosis group(P<0.05).The proportion of persistent ST-T chan-ges in the poor prognosis group was significantly lower than that in the good prognosis group,and the proportion of no ST-T changes was significantly higher than t

关 键 词：血清神经元特异烯醇化酶 心电图缺血性ST-T变化 老年急性脑梗死 

分 类 号：R743[医药卫生—神经病学与精神病学]