论著
目的 探讨复方脑肽节苷脂注射液联合阿替普酶静脉溶栓治疗急性缺血性脑卒中的疗效。方法 选择2019年6月—2023年1月在河南省许昌中医院诊治的79例缺血性脑卒中患者,按照入院就诊顺序采用奇偶法把患者分为联合组40例与传统组39例。传统组给予阿替普酶静脉溶栓治疗,联合组给予复方脑肽节苷脂注射液联合阿替普酶静脉溶栓治疗,评价与记录联合组与传统组的疗效与安全性及治疗前、治疗14 d后Fugl-Meyer评定量表(FMA)与改良版Banhel评价指数(MBI)、血清β-内啡肽、前列腺素E2(PGE2)水平变化。结果 治疗14 d后联合组的总有效率更高(97.5% vs 82.1%,P<0.05),并发症发生率更低(5.0% vs 20.5%,P<0.05)。联合组与传统组治疗14 d后的FMA与MBI评分高于治疗前(P<0.05),联合组治疗14 d后的FMA评分、MBI评分比传统组提高(P<0.05)。联合组与传统组治疗14 d后的血清β-内啡肽、PGE2水平低于治疗前(P<0.05),联合组治疗14 d后的血清β-内啡肽、PGE2水平低于传统组(P<0.05)。结论 复方脑肽节苷脂注射液联合阿替普酶静脉溶栓治疗急性缺血性脑卒中能提高效果,降低患者的肺部感染、尿路感染、静脉血栓、褥疮等并发症发生率,改善患者的运动与日常生活功能,还可降低患者血清β-内啡肽、PGE2水平。
Objective To explore and analysis the efficacy and safety of compound brain peptide ganglioside injection combined with alteplase intravenous thrombolysis in the treatment of acute ischemic stroke. Methods From June 2019 to January 2023,79 patients with ischemic stroke who were diagnosed and treated at Henan Xuchang Traditional Chinese Medicine Hospital were selected as the research subjects.According to the order of admission,the patients were divided into the combination group of 40 cases and the traditional group of 39 cases.The traditional group received intravenous thrombolytic therapy with alteplase,while the combination group received treatment with compound brain peptide ganglioside injection on the basis of the traditional group.The efficacy and safety and changes of the Fugl-Meyer rating Scale(FMA)and modified Banhel Evaluation Index(MBI),serum β-endorphin,and PGE 2 levels in the combined and traditional groups were evaluated and recorded. Results After 14 days of treatment,the combined group had a higher overall response rate(97.5% vs 82.1%,P<0.05)and a lower complication rate(5.0% vs 20.5%,P<0.05).FMA scores and MBI scores of the two groups after 14 days of treatment were higher than those before treatment(P<0.05),and FMA scores and MBI scores of the combined group after 14 days of treatment were higher than those of the traditional group(P<0.05).The contents of β-endorphin and prostaglandin E2 in two groups after 14 days of treatment were lower than those before treatment(P<0.05),and the contents of β-endorphin and prostaglandin E2 in combination group after 14 days of treatment were lower than those in traditional group(P<0.05). Conclusions The combination of compound brain peptide ganglioside injection and alteplase intravenous thrombolysis in the treatment of acute ischemic stroke can improve the treatment effect,reduce the incidence of complications such as pulmonary infections,urinary tract infections,venous thrombosis and bedsores in patients,improve patients' motor and daily life functions,and also reduce patients' serum levels of β-endorphins and prostaglandin E2.
中西医结合/中医研究
目的 探索以解语丹联合靳三针为基础的不同治疗方案对卒中后失语症(PSA)的治疗效果。方法 收集广州市第一人民医院神经内科、中医科PSA患者120例,随机分为解语丹组、靳三针组、联合组和对照组,每组各30例。试验组除给予常规卒中治疗外,分别给予解语丹、靳三针及解语丹联合靳三针治疗,对照组仅给予常规卒中治疗,治疗周期共12周。分别利用西方失语成套测验(WAB)、汉语失语检查量表(ABC)、副反应量表(TESS)于试验前、试验2周及12周时对患者进行评估,并进行药物安全性评价,观察解语丹联合靳三针治疗卒中后失语症的临床治疗效果。结果 经2周治疗后,试验组各组WAB中的失语指数(AQ)、操作指数(PQ)、大脑皮质指数(CQ)评分分别为68.14±7.23;67.26±7.23;69.73±6.97、15.47±3.91;15.92±6.35;18.06±7.83、66.84±7.85;65.78±6.75;70.35±6.73,均较治疗前及对照组有明显改善,比较差异有统计学意义(P<0.05);试验组各组比较,联合组各项评分优于解语丹组和靳三针组,比较差异有统计学意义(P<0.05);治疗12周后,试验组WAB的AQ、PQ、CQ评分分别为91.87±7.81;85.75±6.87;94.58±7.83、31.57±7.38;25.67±6.28;35.72±8.31、89.74±6.98;84.16±6.79;93.56±7.88,与治疗2周后比较,差异有统计学意义(P<0.05)。言语功能各亚项评分显示,联合组在口语表达、听理解、复述、命名等方面优于其他各组,两两比较差异有统计学(P<0.05)。试验各组在2周及12周时,TESS评分比较差异无统计学意义(P<0.05)。统计分析表明,解语丹联合靳三针治疗卒中后失语症,2周后起效12周后效果更为明显。结论 解语丹联合靳三针早期治疗PSA患者能有效提升认知功能,改善患者的言语功能,提高患者的人际交往和生活自理能力,且具有较好的安全性,无严重不良反应,可为临床治疗PSA提供一种新的方法。
Objective To compare the therapeutic effects of different treatment plans based on Jieyu Dan combined with Jin's Three Needle on aphasia patients after stroke.Methods A total of 120 patients with aphasia after stroke in the neurology and traditional Chinese medicine departments of Guangzhou First People's Hospital were collected and randomly divided into Jieyu Dan group,Jin's Three Needle group,combined group and control group,with 30 cases in each group.The treatment groups were treated with Jieyu Dan,Jin's Three Needle and Jieyu Dan combined with Jin's Three Needle respectively,in addition to conventional stroke treatment.The control group was only treated with conventional stroke treatment,with a total treatment period of 12 weeks.The Western Aphasia Battery(WAB),Aphasia Battery of Chinese(ABC)and Treatment Emergent Symptom Scale(TESS)were used to evaluate patients before,at 2 weeks and 12 weeks of the trial,and drug safety was evaluated to observe the clinical therapeutic effect of Jieyu Dan combined with Jin's Three Needle in treating post stroke aphasia.Results After 2 weeks of treatment,the aphasia quotient(AQ),performance quotient(PQ),cortical quotient(CQ)scores of WAB in each group of the experimental group were 68.14±7.23,67.26±7.23,69.73±6.97;15.47±3.91,15.92±6.35,18.06±7.83;66.84±7.85,65.78±6.75,70.35±6.73,respectively,and all significantly improved compared to before treatment and the control group,with significant differences(P<0.05).Compared with the experimental group,the combined group had better scores than the Jieyu Dan group and Jin's Three Needle group,with a statistically significant difference(P<0.05).After 12 weeks of treatment,the AQ,PQ,and CQ scores of the experimental group's WAB were 91.87±7.81,85.75±6.87,94.58±7.83;31.57±7.38,25.67±6.28,35.72±8.31;89.74±6.98,84.16±6.79,93.56±7.88,respectively.Compared with 2 weeks of treatment,the difference was statistically significant(P<0.05).The scores of each sub item of speech function showed that the combined group was significantly better than the other groups in terms of oral expression,listening comprehension,retelling,naming,etc.,with statistical significance(P<0.05).At 2 and 12 weeks,there were no significant statistical differences in TESS scores among the experimental groups(P<0.05).Statistical analysis showed that the combination of Jieyu Dan and Jin's Three Needle in the treatment of post-stroke aphasia had a more significant effect after 2 weeks and 12 weeks.Conclusions The combination of Jieyu Dan and Jin's Three Needle can effectively improve cognitive function and enhance patients' self-care ability in the early treatment of aphasia after stroke.The clinical efficacy is significant and has good safety,making it an effective treatment plan for aphasia after stroke.
综述
脑卒中是临床常见的急性脑血管疾病,常有偏瘫、肩手综合征、下肢深静脉血栓等后遗症,严重影响患者的生活质量。温针疗法是中医传统的特色疗法,近年来,应用以温针为主的相关疗法治疗脑卒中后遗症的报道越来越多,在临床上得到广泛应用。本文归纳分析了近10年来温针疗法治疗脑卒中后肩手综合征、偏瘫、下肢深静脉血栓三大主要疾病的案例及研究,以期为相关研究与应用提供参考。
Stroke is a common acute cerebrovascular disease in clinical practice,which frequently leaves sequelae like hemiplegia,shoulder-hand syndrome and deep vein thrombosis of the lower extremities,and vastly reduces the quality of life of patients.Warm needling is a characteristic therapy of traditional Chinese medicine.In recent years,there have been more and more reports of warm needling-based related therapies for the treatment of stroke sequelae,and it has been widely used in clinical practice.This article summarizes and analyzes the cases and studies of warm needing therapy in the treatment of shoulder-hand syndrome,hemiplegia and deep vein thrombosis of the lower extremities after stroke in the past 10 years,so as to provide reference for related research and application.
论著
目的 探讨间歇经口至食管管饲法与自创吞咽功能训练联合应用于脑卒中吞咽障碍患者的效果。方法 选取河南大学淮河医院2022年1月—2023年12月收治的50例脑卒中吞咽障碍患者,应用随机数字表法将其分为两组,每组各25例。对照组采取持续留置鼻饲的同时应用自创吞咽功能训练进行训练,观察组采取间歇经口至食管管饲的同时应用自创吞咽功能训练进行训练。对比两组吞咽障碍改善情况、干预前后营养状况指标及生活质量变化,比较两组并发症发生率。结果 观察组总有效率高于对照组(P<0.05)。干预后两组血清总蛋白、白蛋白和血红蛋白水平和体质量指数均升高,观察组高于对照组(P<0.05)。干预后两组生活质量综合评定量表评分升高,观察组高于对照组(P<0.05)。观察组并发症发生率低于对照组(P<0.05)。结论 对脑卒中吞咽功能障碍患者采取间歇经口至食管管饲法与自创吞咽功能训练,能够更有效改善患者吞咽功能,提升其生活质量,且可降低留置饲管营养支持过程中的并发症发生率。
Objective To explore the application effect of intermittent oral to esophageal feeding combined with self created swallowing function training exercises in stroke patients with swallowing disorders.Methods Fifty stroke patients with swallowing disorders admitted to our hospital from January 2022 to December 2023 were selected and divided into two groups by random number table method,both with 25 cases.Control group patients received continuous nasogastric feeding while using solf created swallowing function training exercises for training,while observation group patients received intermittent oral to oesophageal tube feeding and using solf created swallowing function training exercises for training.The improvement of swallowing disorders,changes in nutritional status indicators and quality of life before and after the intervention were compared,and also the frequency of complications.Results The observation group was generally more effective than the control group(P<0.05).After intervention,the serum total protein,albumin hemoglobin,and BMI levels of both groups of patients increased,with the observation group being higher than the control group(P<0.05).After the intervention,GQOLI-74 score increased in both groups,and the observation group was higher than the control group(P<0.05).The complication rate was lower in the observation group(P<0.05).Conclusions The intervention method of intermittent oral to esophageal tube feeding combined with self created swallowing function training exercises can further improve the swallowing function of stroke patients with swallowing dysfunction,improve their quality of life,and reduce the occurrence of complications during the nutritional support process of feeding tubes.
论著
目的 探讨良肢位训练联合风险预控急救应用于重症脑卒中的效果。方法 采用回顾性分析,纳入我院2020年3月—2021年3月期间收治的41例重症脑卒中患者为对照组,救治方式为常规救治联合良肢位训练。同时纳入我院2021年4月—2022年4月期间收治的41例重症脑卒中患者为观察组,救治方式为良肢位训练联合风险预控急救。对比2组抢救情况、抢救效果、运动功能。结果 观察组院外吸氧率(46.34%)、院外插管率(34.15%)均高于对照组(17.07%、9.76%),转入专科治疗时间、发病至入院时间均短于对照组(P<0.05);干预3 d后,观察组格拉斯哥昏迷量表分值高于对照组,APACHEⅡ评分分值低于对照组(P<0.05);观察组Fugl-Meyer运动评估、Berg平衡量表分值均高于对照组,NIHSS量表分值低于对照组(P<0.05)。结论 良肢位训练联合风险预控急救应用于重症脑卒中可有效改善抢救情况、提升抢救效果,从而增强运动功能。
Objective To explore the effect of normal extremity position training combined with risk pre-control emergency treatment in severe stroke.Methods Forty-one severe stroke patients from March 2020 to March 2021 included in the control group were retrospective studied,and the treatment method was conventional treatment combined with normal extremity position training.At the same time,41 severe stroke patients from April 2021 to April 2022 were included in the observation group,which the treatment method was the risk pre-control and emergency treatment.The rescue situation,rescue effect and sports function of the two groups were compared.Results Incidences of oxygen inhalation(46.34%)and intubation(34.15%)outside the hospital in observation group were higher than that in control group(17.07%,9.76%);specialist treatment,onset to admission time were longer in control group(P<0.05).Glasgow coma scale score in observation group was higher than that in control group,while APACHE Ⅱ score was lower in observation group(P<0.05),Fugl-Meyer assessment and Berg Balance Scale score were higher,and NIHSS score was lower than control group(P<0.05).Conclusions Combination of normal extremity position training and risk pre-control emergency treatment in severe stroke treatment can effectively improve the rescue effect,thus enhance the motor function.
论著
目的 评价银杏二萜内酯葡胺注射液(DGMI)联合依达拉奉右崁对急性缺血性脑卒中(AIS)的治疗效果。方法 回顾性分析我院2021年3月—2022年6月收治的86例AIS患者,根据治疗方法不同,分为单药组和联合组,每组43例,2组均予以DGMI治疗,联合组加用依达拉奉右崁醇。对比2组的治疗效果。结果 治疗后,联合组美国国立卫生研究院卒中量表(NIHSS)评分低于单药组(P<0.05),简易智能精神状态检查量表(MMSE)和Barthel指数(BI)得分高于单药组(P<0.05);联合组治疗后脑血流动力学指标(Qmin和Vmin)高于单药组(P<0.05),而全血还原黏度、血浆黏度和血小板聚集指数低于单药组(P<0.05);联合组治疗后血清丙二醛(MDA)、超敏C-反应蛋白(hsCRP)和白细胞介素-6(IL-6)低于单药组(P<0.05),而超氧化物歧化酶(SOD)高于单药组(P<0.05);联合组治疗总有效率88.37%,高于单药组的67.44%(P<0.05),且2组不良反应总发生率比较差异无统计学意义(P>0.05)。结论 DGMI联合依达拉奉右崁醇可有效提高AIS患者的神经功能、认知功能及日常生活能力,降低血液高凝状态,改善脑部血流,缓解机体氧化应激及炎症反应,且不良反应发生率较低,安全性良好。
Objective To evaluate the clinical efficacy of diterpene ginkgolides meglumine injection(DGMI)combined with edaravone dextracanthol in the treatment of acute ischemic stroke(AIS).Methods A total of 86 patients with AIS admitted to our hospital from March 2021 to June 2022 were divided into single drug group and combination group according to different treatment methods,with 43 patients in each group.Both groups were treated with DGMI,and the combination group was added with edaravone dextracanthol.The therapeutic effect,neurological function and adverse reactions of the two groups were compared.Results After treatment,compared with the single drug group,the NIH Stroke Scale(NIHSS)score of the combination group was significantly lower(P<0.05),and the Mini-Mental State Examination(MMSE)and Barthel index(BI)scores were significantly higher(P<0.05).After treatment,the cerebral hemodynamic indexes(Qmin and Vmin)in the combination group were significantly higher(P<0.05),while the whole blood reducing viscosity,plasma viscosity and platelet aggregation index were significantly lower(P<0.05).After treatment,compared with the single drug group,the serum malondialdehyde(MDA),high sensitive C-reactive protein(hsCRP)and interleukin- 6(IL-6)levels in the combination group were significantly lower(P<0.05),while the level of superoxide dismutase(SOD)was significantly higher(P<0.05).The total effective rate of the combination group was 88.37%,which was significantly higher than 67.44% of the single drug group(P<0.05).The incidence of adverse reaction between two groups was not significant(P>0.05).Conclusions DGMI combined with edaravone dextracanthol can effectively improve the neurological function,cognitive function and daily living ability of patients with AIS,reduce blood hypercoagulability,improve cerebral blood flow,alleviate oxidative stress and inflammatory reaction,improve the therapeutic effect,without increasing the incidence of adverse reactions,which has good safety.
论著
目的 比较单纯康复训练和在此基础上结合苍龟探穴针法对脑卒中后肩手综合征I期的临床疗效差异。方法 选择响水县人民医院疼痛康复科收治的卒中后出现肩手综合征I期患者60例,按随机数字表法分为治疗组(n=30)和对照组(n=30)。治疗组患者行与苍龟探穴中医针法结合康复训练,先由具备针灸专业主治资格的临床医师对所选取的部分穴位使用苍龟探穴中医传统针法实施治疗后,再由具有5年以上工作经历的康复治疗师实施治疗,而其他患者则单纯接受康复训练,并观察2组患者在治疗前和治疗后的视觉模拟评分(VAS)、肿胀程度、简式上肢运动功能(Fugl-Meyer)评估以及临床疗效。结果 本次研究临床治疗进程中,2组无不良反应情况出现,因疫情和不能配合治疗而出现5例脱落病例(治疗组2例,对照组3例)。①治疗后,2组患者的VAS和肿胀程度评分低于治疗前(P<0.01),治疗组患者2项评分高于治疗前(P<0.05);②治疗后,2组患者的Fugl-Meyer评分高于治疗前(P<0.01),治疗组患者评分高于对照组(P<0.01);③治疗组的有效率高于对照组,组间比较差异有统计学意义(P<0.05)。结论 苍龟探穴中医传统针法结合康复训练可减少患者水肿和酸痛情况,明显改善患者上肢运动能力,有良好的临床效果。
Objective To compare the clinical efficacy of rehabilitation training alone and the combination of Cangguitanxue acupuncture on post-stroke stage I shoulder-hand syndrome.Methods A total of 60 patients from the Department of Rehabilitation Medicine of Xiangshui County People's Hospital who met the diagnosis(stroke followed by stage I shoulder-hand syndrome)were selected, and they were randomly divided into treatment group(n=30)and control group(n=30)according to the random number table method.Patients in the treatment group underwent a combination of rehabilitation training with the Cangguitanxue acupuncture Chinese medicine acupuncture method, and were first treated by a clinician qualified in acupuncture using the Cangguitanxue acupuncture Chinese medicine traditional acupuncture method on selected acupoints, and then by a rehabilitation therapist with more than five years of experience, while other patients received rehabilitation treatment alone.Results In the clinical treatment process of this study, there were no adverse reactions in the two groups, but there were five cases of dropout due to the epidemic and the inability to cooperate with the treatment(two cases in the treatment group and three cases in the control group).After treatment, the visual analogue scale(VAS)and swelling degree scores of the two groups were significantly lower than those before treatment(P<0.01), and the performance of the patients in the treatment group was better than that before treatment(P<0.05).After treatment, the score of simplified upper limb motor control function(Fugl-Meyer)score in the two groups was significantly higher than that before treatment(P<0.01), and the score of patients in the treatment group was higher than that of the control group(P<0.01).The effective rate of the control group was inferior to that of the treatment group, and the difference was statistically significant(P<0.05).Conclusions The traditional acupuncture method combined with rehabilitation training can significantly reduce edema and soreness in patients, significantly improve upper limb motor ability, and have good clinical effects.
论著
目的 探讨血清心型脂肪酸结合蛋白(H-FABP)、血管生成素-1(Ang-1)在急性大血管闭塞性卒中(AIS-LVO)静脉溶栓桥接支架取栓患者预后中的评估价值。方法 选择2019年1月—2021年5月80例AIS-LVO患者作为研究对象,均接受静脉溶栓桥接支架取栓治疗,检测术前血清H-FABP、Ang-1水平,术后随访90 d将患者分为预后良好组(n=57)与预后不良组(n=23)。结果 两组在高血压、冠心病、心房颤动、急性卒中治疗低分子肝素试验(TOAST)分型、侧支循环、术前H-FABP、术前Ang-1方面存在差异(P<0.05)。多因素 Logistic 回归分析结果显示,高血压、心房颤动、心源性梗死型、侧支循环为0 ~1 级、术前H-FABP≥10.0 ng/L、术前Ang-1<5.25 ng/mL是AIS-LVO静脉溶栓桥接支架取栓患者预后不良的危险因素。术前血清H-FABP预测术后90 d预后不良的AUC为0.728(95%CI:0.368~0.918),灵敏度、特异度分别为66.68%、58.92%。术前血清Ang-1预测术后90 d预后不良的AUC为0.773(95%CI:0.592~1.129),灵敏度、特异度分别为70.35%、63.92%。H-FABP联合Ang-1预测术后90 d预后不良的AUC为0.854(95%CI:0.652~0.957),灵敏度、特异度分别为77.18%、71.82%。结论 静脉溶栓桥接支架取栓治疗AIS-LVO患者的预后受到多种危险因素的影响,其中术前血清H-FABP和Ang-1是具有前景的预后预测因子。
Objective To investigate the prognostic value of serum heart-type fatty acid binding protein(H-FABP)and angiopoietin-1(Ang-1)in patients with acute ischemic stroke-large vessel occlusion(ALS-LVO)undergoing venous thrombolytic bridging stent thrombectomy.Methods A total of 80 patients with ALS-LVO from January 2019 to May 2021 were selected as the study subjects,treated with intravenous thrombolytic bridging stent thrombectomy,and their serum H-FABP and Ang-1 levels were measured before operation.After 90 days of follow-up,the patients were divided into good prognosis group(n=57)and poor prognosis group(n=23).Results There were significant differences between the two groups in hypertension,coronary heart disease,atrial fibrillation,TOAST classification,collateral circulation,preoperative H-FABP,and preoperative Ang-1(P<0.05).Multivariate logistic regression analysis showed that hypertension,atrial fibrillation,cardiogenic infarction type,collateral circulation of 0~1 grade,preoperative H-FABP≥10.0 ng/L,preoperative Ang-1<5.25 ng/mL were independent risk factors for poor prognosis of ALS-LVO patients treated with venous thrombolytic bridging stents.The AUC of preoperative serum H-FABP predicting poor prognosis 90 days after operation was 0.728(95%CI:0.368~0.918),with sensitivity and specificity of 66.68% and 58.92% respectively.The AUC of preoperative serum Ang-1 predicting poor prognosis 90 days after surgery was 0.773(95%CI:0.592~1.129),with sensitivity and specificity of 70.35% and 63.92% respectively.The AUC predicted by H-FABP combined with Ang-1 for poor prognosis 90 days after operation was 0.854(95%CI:0.652~0.957),and the sensitivity and specificity were 77.18% and 71.82% respectively.Conclusions The prognosis of patients with ALS-LVO treated with intravenous thrombectomy bridging stent thrombectomy is affected by many risk factors,among which preoperative serum H-FABP and Ang-1 are promising prognostic factors.
论著
目的 评估全身免疫炎症指数(SII)、中性粒细胞/淋巴细胞比值(NLR)和血小板/淋巴细胞比值(PLR)在区分急性缺血性卒中(AIS)伴发卵圆孔未闭(PFO)与非伴发PFO患者的价值。方法 回顾性分析100例AIS患者的血液和血清指标,计算SII、NLR和PLR,使用Logistic回归及受试者操作特征(ROC)曲线分析3项指标在鉴别AIS伴发PFO与非伴发PFO中的价值。结果 伴发PFO的AIS患者SII、NLR、PLR高于非伴发PFO的AIS患者,其中以SII最为明显(P均<0.05)。单因素Logistic回归显示,中性粒细胞计数、淋巴细胞计数、PLR、NLR、SII与AIS伴发PFO有关(P<0.05)。ROC曲线分析结果,SII、NLR、PLR鉴别AIS伴PFO与非伴PFO患者,最佳阈值分别为476.4、1.99、115.3,曲线下面积分别为0.777、0.767、0.708。结论 SII、NLR和PLR可作为鉴别AIS患者是否伴发PFO的生物标志物,具有潜在临床应用价值。
Objective To evaluate the value of systemic immune-inflammatory index(SII),neutrophil/lymphocyte ratio(NLR)and platelet/lymphocyte ratio(PLR)in distinguishing acute ischemic stroke(AIS)patients with patent foramen ovale(PFO)and without PFO.Methods A retrospective analysis of blood and serum indicators in 100 AIS patients was conducted,and SII,NLR and PLR indices were calculated.Logistic regression and ROC curve analyses were performed.Results SII,NLR and PLR were significantly higher in PFO patients than in non-PFO patients,with SII being the most significant.Univariate logistic regression showed that Neu,Lym,PLR,NLR,and SII variables were significantly associated with AIS combined with PFO(P<0.05).ROC curve analysis revealed that the optimal cut-off values for SII,NLR and PLR in distinguishing AIS patients with PFO from those without PFO were 476.4,1.99 and 115.3,respectively,with area under the curve of 0.777,0.767 and 0.708.Conclusions SII,NLR and PLR can serve as biomarkers for identifying AIS patients with PFO,offering potential clinical application value.
临床诊疗
目的 探讨个体化肠内营养联合电动起立床训练对老年脑卒中卧床患者器官功能的影响。方法 严格执行纳排标准后前瞻性选取2021年7月—2022年9月期间我院收治的97例老年脑卒中卧床患者作为研究对象,按照随机数字表法分为单一组48例给予脑卒中基础干预,联合组49例给予个体化肠内营养联合电动起立床训练干预,观察2组患者营养状况、肺功能指标以及心功能指标。结果 干预4周后,2组血清前蛋白、血清白蛋白、血红蛋白水平均上升且联合组高于单一组(P<0.05);2组用力肺活量(FVC)、第1秒用力呼吸容积(FEV1)、FEV1/FVC均上升且联合组高于单一组(P<0.05);联合组左心室收缩期内径、左室舒张末期内径低于单一组,联合组左心室射血分数高于单一组(P<0.05)。结论 个体化肠内营养联合电动起立床训练干预可有效改善老年脑卒中卧床患者营养状况及心肺功能,促进其机体功能的恢复。