广州医药 ›› 2024, Vol. 55 ›› Issue (7): 764-769.DOI: 10.3969/j.issn.1000-8535.2024.07.011

• 论著 • 上一篇    下一篇

常见炎性指标与进展性脑梗死病灶损害程度的关联及对预后的预测效能分析

杨六红, 陈翔   

  1. 平顶山市第二人民医院神经内四科(河南平顶山 467000)
  • 收稿日期:2023-09-13 出版日期:2024-07-20 发布日期:2024-08-21
  • 基金资助:
    河南省医学科技攻关计划项目(LHGJ20200183)

Analysis of the correlation between common inflammatory indicators and the degree of damage to progressive cerebral infarction lesions and their predictive efficacy for prognosis

YANG Liuhong, CHEN Xiang   

  1. Department of Neurology,Pingdingshan Second People's Hospital,Pingdingshan 467000,China
  • Received:2023-09-13 Online:2024-07-20 Published:2024-08-21

摘要: 目的 分析常规炎性指标与进展性脑梗死(PCI)患者病灶损害程度的关联,及其对预后水平的预测效能。方法 采用回顾性研究,纳入2021年6月—2023年2月平顶山市第二人民医院收治的100例PCI患者,根据入院时神经功能缺损评分(NIHSS)结果,将NIHSS评分≥21分的30例患者列为重度组,将NIHSS评分15~20分的35例患者列为中度组,将NIHSS评分<15分的35例患者列为轻度组,比较三组患者的神经功能血清学指标及炎症指标,经Pearson相关性分析炎症指标与神经功能血清学指标的相关性;根据是否发生不良预后将入组患者分为预后良好组和预后不良组,比较两组患者各炎症指标及改良Rakin量表(mRS)评分间的差异,并通过绘制受试者操作特征(ROC)曲线、曲线下面积(AUC)评估炎症指标对PCI患者预后水平的预测效能。结果 重度组患者的C-反应蛋白(CRP)、白细胞介素-6(IL-6)、肿瘤坏死因子-α(TNF-α)分别为(26.44±5.18)mg/L、(95.28±10.46)ng/L、(45.24±10.31)pg/mL,均高于中度组[(23.12±5.46)mg/L、(90.44±10.17)ng/L、(40.25±10.18)pg/mL],轻度组[(20.28±5.33)mg/L、(84.33±10.27)ng/L、(35.62±8.45)pg/mL],差异具有统计学意义(P<0.05)。重度组的神经元特异性烯醇化酶(NSE)、S100钙结合蛋白β(S100β)分别为(25.45±5.69)μg/L、(60.45±10.31)ng/mL,均高于中度组[(22.18±5.36)μg/L、(55.27±10.46)ng/mL],轻度组[(19.44±5.37)μg/L、(50.49±10.25)ng/mL],差异具有统计学意义(P<0.05)。经Pearson相关性分析,PCI患者的CRP、IL-6、TNF-α等常见炎性指标水平与NSE、S100β等神经功能血清学指标水平正相关(P<0.05)。经检测,预后不良组的CRP、IL-6、TNF-α、mRS分别为(26.62±5.31)mg/L、(96.77±10.24)ng/L、(47.25±10.33)pg/mL、(4.24±1.33)分,均高于预后良好组[(23.75±5.44)mg/L、(91.25±10.37)ng/L、(41.12±10.44)pg/mL,(3.36±0.27)分],差异具有统计学意义(P<0.05)。经ROC曲线验证,CRP、IL-6、TNF-α等常见炎性指标水平越高,PCI患者的mRS评分越高(AUC均>0.85)。结论 CRP、IL-6、TNF-α等常见炎性指标会随PCI患者脑神经功能损伤程度加剧而不断升高,与病灶损害程度正相关;通过检测上述炎性指标能实现对患者不良预后的早期预测。

关键词: 进展性脑梗死, 炎性指标, 神经功能, 相关性分析, 预后水平

Abstract: Objective To analyze the correlation between routine inflammatory indicators and the degree of lesion damage in progressive cerebral infarction(PCI) patients,as well as predictive efficacy of indicators on prognosis levels.Methods This is a retrospective study,with case enrollment from June 2021 to February 2023.The study subjects were 100 PCI patients.Based on the NIHSS score at admission,30 patients with a NIHSS score ≥ 21 were classified as the severe group,35 patients with a NIHSS score of 15~20 were classified as the moderate group,and 35 patients with a NIHSS score <15 were classified as the mild group.The neurological function serological and inflammatory indicators of the three groups of patients were compared.The correlation between inflammatory indicators and neurological serological indicators was verified by Pearson correlation coefficient.According to the occurrence of adverse prognosis,enrolled patients were divided into good prognosis group and poor prognosis group.The differences in inflammatory indicators and mRS scores between the two groups were compared,and the predictive power of inflammatory indicators on the prognosis level of PCI patients was evaluated by plotting ROC and observing AUC.Results After testing,the levels of CRP,IL-6 and TNF in the severe group were(26.44±5.18)mg/L,(95.28±10.46)ng/L and(45.24±10.31)pg/mL,respectively,higher than those in the moderate group[(23.12±5.46)mg/L,(90.44±10.17)ng/L and(40.25±10.18)pg/mL]and the mild group[(20.28±5.33)mg/L,(84.33±10.27)ng/L and(35.62±8.45)pg/mL](P<0.05).NSE and S100β in the severe group were(25.45±5.69)μg/L and(60.45±10.31)ng/mL,all higher than those in the moderate group[(22.18±5.36)μg/L,(55.27±10.46)ng/mL]and mild group[(19.44±5.37)μg/L,(50.49±10.25)ng/mL](P<0.05).According to Pearson correlation coefficient test,CRP,IL-6,TNF-α and mRS in PCI patients positively correlated with NSE,S100β(P<0.05).After testing,CRP,IL-6,TNF-α and mRS in the group with poor prognosis were(26.62±5.31)mg/L,(96.77±10.24)ng/L,(47.25±10.33)pg/mL and(4.24±1.33)scores,respectively,which were higher than those in the group with good prognosis[(23.75±5.44)mg/L,(91.25±10.37)ng/L,(41.12±10.44)pg/mL and(3.36±0.27)scores](P<0.05).Verified by ROC curve,the higher the levels of CRP,IL-6 and TNF- α,the higher the mRS scores of PCI patients(AUC>0.85).Conclusions Common inflammatory indicators such as CRP,IL-6 and TNF- α of PCI will continue to increase with the severity of brain nerve function damage in patients,and are positively correlated with the degree of lesions damage.By detecting the aforementioned inflammatory indicators,early prediction of poor prognosis can be achieved for patients.

Key words: progressive cerebral infarction, inflammatory indicators, neurological function, correlation analysis, prognostic level