论著

基于Caprini量表评估的干预模式联合充气加压泵预防慢性阻塞性肺疾病急性加重期患者静脉血栓的效果

Effect of intervention mode based on Caprini score combined with inflatable pump in preventing VTE in patients with AECOPD

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      目的 观察慢性阻塞性肺疾病急性加重期(AECOPD)患者应用基于Caprini量表评估的干预模式联合充气加压泵(IPC)预防静脉血栓(VTE)的效果。方法 选取河南省人民医院在2023年11月—2024年11月收入的82例AECOPD患者作为研究对象,经随机数表法分为对照组41例予以VTE常规干预,观察组41例在对照组的基础上接受基于Caprini量表评估的干预模式联合IPC预防。比较两组AECOPD患者肢体情况及深静脉血栓(VTE)发生情况、凝血指标及股静脉血流速度。结果 观察组肢体肿胀率、肢体疼痛率及VTE发生率均低于对照组(P<0.05)。干预前,两组AECOPD患者凝血酶时间(TT)、凝血酶原时间(PT)、活化部分凝血活酶时间(APTT)、D-二聚体水平比较差异无统计学意义(P>0.05);干预后,两组患者TT、PT、APTT、D-二聚体水平均降低,观察组较低(P<0.05)。干预前,两组AECOPD患者平均流速、血流峰速及阻力指数比较差异无统计学意义(P>0.05);干预后,两组患者平均流速、血流峰速均升高,观察组高于对照组(P<0.05);阻力指数均降低,观察组低于对照组(P<0.05)。结论 AECOPD患者应用基于Caprini量表评估的干预模式联合IPC能有效降低肢体肿胀率、肢体疼痛率及VTE发生率,改善凝血指标与股静脉血流速。
   Objective To observe the effect of a Caprini score?based intervention model combined with intermittent pneumatic compression(IPC)in preventing venous thromboembolism(VTE)in patients with acute exacerbation of chronic obstructive pulmonary disease(AECOPD).Methods A total of 82 AECOPD patients admitted to Henan Provincial People’s Hospital from November 2023 to November 2024 were selected as subjects and randomly divided into a control group(41 cases)and an observation group(41 cases)using a random number table.The control group received routine VTE prevention,while the observation group received the Caprini score?based intervention combined with IPC in addition to the routine care.The extremity conditions,occurrence of VTE,coagulation parameters,and femoral venous blood flow velocity were compared between the two groups.Results The rates of extremity swelling,extremity pain,and VTE incidence in the observation group were lower than those in the control group(P<0.05).Before the intervention,there were no statistically significant differences in thrombin time(TT),prothrombin time(PT),activated partial thromboplastin time(APTT),or D?dimer levels between the two groups(P>0.05).After the intervention,TT,PT,APTT,and D?dimer levels decreased in both groups,with lower values in the observation group(P<0.05).Before the intervention,there were no statistically significant differences in mean flow velocity,peak flow velocity,or resistance index between the two groups(P>0.05).After the intervention,mean flow velocity and peak flow velocity increased in both groups,with higher values in the observation group(P<0.05),while the resistance index decreased,with a lower value in the observation group(P<0.05).Conclusions The application of a Caprini score?based intervention model combined with IPC in AECOPD patients can effectively reduce the rates of extremity swelling,extremity pain,and VTE incidence,and improve  coagulation parameters and femoral venous blood flow velocity.

入院时血清SAA、ApoA1、CRP水平联合检测对老年急性脑梗死患者规范治疗后3个月内发生预后不良的早期预测效能

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目的 探讨入院时血清淀粉样蛋白A(SAA)、载脂蛋白A1(ApoA1)、C反应蛋白(CRP)水平联合检测对老年急性脑梗死(ACI)患者规范治疗后3个月内发生预后不良的早期预测效能。方法 前瞻性选取2023年1月~2025年1月于焦作市第五人民医院就诊的108例老年ACI患者作为ACI组,另选取同期健康志愿者108例作为对照组。比较两组血清SAA、ApoA1、CRP水平。老年ACI患者予以规范治疗,根据治疗后3个月内预后情况将其分为预后不良(46例)和预后良好(62例)亚组,比较不同预后ACI患者患者临床资料及入院时血清SAA、ApoA1、CRP水平;Logistic回归分析入院时血清SAA、ApoA1、CRP水平是否为老年ACI患者规范治疗后3个月内发生预后不良的独立影响因素;ROC曲线分析入院时血清SAA、ApoA1、CRP水平联合检测对ACI患者预后不良的预测效能。结果 ACI组入院时血清SAA、CRP水平高于对照组,血清ApoA1水平低于对照组(P<0.05);预后不良亚组高血压占比、入院NIHSS评分、梗死体积、入院时血清SAA、CRP水平高于预后良好亚组,血清ApoA1水平低于预后良好亚组(P<0.05);剔除存在多重共线性指标高血压、入院NIHSS评分、梗死体积后,入院时血清SAA、ApoA1、CRP水平仍是老年ACI患者规范治疗后3个月内发生预后不良的独立影响因素(P<0.05);入院时血清SAA、ApoA1、CRP水平联合预测ACI患者预后不良的AUC值为0.873,显高于各指标单独预测值0.738、0.768、0.749(P<0.05)。结论 入院时血清SAA、ApoA1、CRP水平是老年ACI患者预后不良的独立影响因素,联合检测对预后不良具有较高的预测效能,可将其作为ACI患者血清敏感指标,协助临床医师早期制定针对性干预措施,减少ACI患者预后不良的发生。

发病48 h内依达拉奉右莰醇注射用浓溶液治疗急性缺血性卒中患者的真实世界用药特征及短期预后分析

Real-World Treatment Characteristics and Short-Term Prognosis of Edaravone Dexborneol in Patients With Acute Ischemic Stroke Treated Within 48 Hours of Onset

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目的:描述发病48 h内急性缺血性卒中(acute ischemic stroke,AIS)患者依达拉奉右莰醇真实世界用药特征,探讨48 h内不同启动时间与住院期间神经功能改善及短期预后的关系。方法:回顾性连续筛选2023年12月1日至2026年4月30日本院诊断为AIS并使用依达拉奉右莰醇的住院患者,药学部基于药学信息系统、住院医嘱及病历记录提取资料。初筛147例,排除35例,纳入112例发病至首次用药时间(onset-to-treatment time,OTT)≤48 h者;按预设24 h界值分为24 h内用药组(n=67)和24~48 h用药组(n=45)。主要结局为住院期间美国国立卫生研究院卒中量表(National Institutes of Health Stroke Scale,NIHSS)变化值(ΔNIHSS=入院NIHSS评分-出院前NIHSS评分);次要结局包括出院前NIHSS评分、出院改良Rankin量表(modified Rankin Scale,mRS)评分、显著神经功能改善、住院时间、出院去向及安全性事件。采用多因素线性回归分析24 h内用药与ΔNIHSS的相关性,并行简化模型、排除再灌注治疗患者、完整疗程人群、进一步调整大血管闭塞及OTT连续变量模型等敏感性分析。结果:总体OTT为19.65(14.97,34.68)h,疗程12.00(11.00,13.00)d,完成相对完整疗程比例89.3%。两组入院NIHSS评分差异无统计学意义[8.00(6.00,9.00)分 vs 8.00(6.00,10.00)分,P=0.447];24 h内用药组出院前NIHSS评分更低[5.00(4.00,6.50)分 vs 6.00(5.00,8.00)分,P=0.025],ΔNIHSS更高[3.00(2.00,3.00)分 vs 2.00(1.00,2.00)分,P<0.001],显著神经功能改善率更高(77.6% vs 60.0%,P=0.045)。多因素校正后,24 h内用药仍与更大的ΔNIHSS相关(β=0.768,95%CI:0.377~1.159,P<0.001);Logistic探索性分析显示其与显著神经功能改善发生可能性较高相关(OR=2.475,95%CI:1.047~5.853,P=0.039)。两组出血转化、症状性颅内出血、药物相关不良反应及院内死亡差异均无统计学意义。结论:本单中心真实世界队列中,发病48 h内依达拉奉右莰醇治疗疗程完成比例较高、短期安全性事件发生率低;24 h内启动治疗与住院期间NIHSS改善幅度较大及显著神经功能改善率较高相关。由于为回顾性观察性研究,结果应解释为关联性证据,需前瞻性、多中心研究及长期功能结局验证。
Objective: To describe real-world treatment characteristics of edaravone dexborneol in acute ischemic stroke (AIS) patients treated within 48 hours of onset and to explore the association between initiation time and short-term in-hospital outcomes. Methods: This single-center retrospective real-world study screened hospitalized AIS patients with edaravone dexborneol records from December 1, 2023 to April 30, 2026. Medication data were extracted from the pharmacy information system, inpatient orders, and medical records. After 35 exclusions, 112 of 147 patients with onset-to-treatment time (OTT) ≤48 h were included and classified by a prespecified 24-hour cutoff into a within-24-hour group (n=67) and a 24-48-hour group (n=45). The primary outcome was in-hospital National Institutes of Health Stroke Scale (NIHSS) change (ΔNIHSS=admission NIHSS minus pre-discharge NIHSS); secondary outcomes included pre-discharge NIHSS, discharge modified Rankin Scale (mRS), marked neurological improvement, length of stay, discharge destination, and safety events. Multivariable linear regression assessed the association between within-24-hour treatment and ΔNIHSS, with sensitivity analyses using simplified adjustment, exclusion of reperfusion-treated patients, the complete-course population, additional adjustment for large-vessel occlusion, and continuous OTT modeling. Results: Median OTT was 19.65 (14.97, 34.68) h, treatment duration was 12.00 (11.00, 13.00) days, and 89.3% completed a relatively complete course. Baseline NIHSS was comparable [8.00 (6.00, 9.00) vs 8.00 (6.00, 10.00), P=0.447]. The within-24-hour group had lower pre-discharge NIHSS [5.00 (4.00, 6.50) vs 6.00 (5.00, 8.00), P=0.025], greater ΔNIHSS [3.00 (2.00, 3.00) vs 2.00 (1.00, 2.00), P<0.001], and a higher marked improvement rate (77.6% vs 60.0%, P=0.045). After adjustment for age, admission NIHSS, reperfusion therapy, and atrial fibrillation, within-24-hour treatment remained associated with greater ΔNIHSS (β=0.768, 95% CI: 0.377-1.159, P<0.001). Exploratory logistic regression showed a higher likelihood of marked improvement (OR=2.475, 95% CI: 1.047-5.853, P=0.039). Hemorrhagic transformation, symptomatic intracranial hemorrhage, drug-related adverse reactions, and in-hospital death did not differ significantly. Conclusion: In this real-world cohort, edaravone dexborneol within 48 h of AIS onset showed a high complete-course proportion and low short-term safety event incidence. Initiation within 24 h was associated with greater in-hospital NIHSS improvement and a higher marked improvement rate than initiation at 24-48 h. These findings are associative and need prospective multicenter validation with long-term functional outcomes.

2024年-2026年郑州人民医院急性下呼吸道感染患儿病原体检测及其流行病学特征分析

Analysis of Pathogen Detection and Epidemiological Characteristics in Children with Acute Lower Respiratory Tract Infections at Zhengzhou People’s Hospital, 2024–2026

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目的 分析2024年2月至2026年2月郑州人民医院收治的急性下呼吸道感染(ALRTI)患儿的病原体分布情况及其流行病学特征。方法 选取2024年2月—2026年2月于郑州人民医院就诊的193例ALRTI患儿为研究对象,采集患儿咽拭子样本,统计患儿病原体检测结果,比较不同性别、不同年龄段、不同发病季节患儿病原体分布情况。结果 193例患儿中,经病原体检测出阳性患儿165例,总阳性检出率85.49%,检出率最高的前三位为RSV(20.73%)、MP(19.69%)、HRV(15.54%);婴儿期患儿RSV感染占比(44.83%)最高,其次为HRV感染(20.69%),幼儿期患儿RSV、HRV、MP感染占比(17.31%、17.31%、19.23%)均较高,学龄前、学龄期患儿MP感染占比(33.33%、26.32%)最高,婴儿期患儿混合感染占比(6.90%)较低,学龄前患儿混合感染占比(20.00%)较高;春季时,各病原体分布较均衡,HRV、MP、SP感染占比(14.58%、12.50%、14.58%)均较高,夏季、秋季时,MP感染率(31.82%、28.85%)较高,冬季时,RSV感染率(55.10%)较高,四个季节中混合感染患儿占比较接近,其中秋季感染率(17.31%)相对较高。结论 2024年至2026年郑州人民医院收治的急性下呼吸道感染患儿病原体中,RSV、MP为主要病原体,各呼吸道病原体随患儿年龄段、季节变化存在不同发病高峰,临床应结合实际情况早期鉴别病原体,以指导临床制定针对性治疗方案,改善患儿预后。
Objective To analyze the distribution of pathogens and the epidemiological characteristics of children with acute lower respiratory tract infections (ALRTI) admitted to Zhengzhou People’s Hospital from February 2024 to February 2026. Methods: A total of 193 pediatric patients with ALRTI who visited Zhengzhou People’s Hospital between February 2024 and February 2026 were selected as study subjects. Throat swab samples were collected from the patients, and pathogen testing results were compiled to compare the distribution of pathogens across different genders, age groups, and seasons of onset. Results: Among the 193 children, 165 tested positive for pathogens, resulting in an overall positive detection rate of 85.49%. The top three most frequently detected pathogens were RSV (20.73%), MP (19.69%), and HRV (15.54%); RSV infection had the highest prevalence (44.83%) among infants, followed by HRV infection (20.69%). Among preschoolers, the prevalence of RSV, HRV, and MP infections (17.31%, 17.31%, and 19.23%, respectively) was relatively high. MP infections were most common among preschool and school-age children (33.33% and 26.32%, respectively); the proportion of mixed infections was lower among infants (6.90%) but higher among preschoolers (20.00%); In spring, the distribution of pathogens was relatively balanced, with high proportions of HRV, MP, and SP infections (14.58%, 12.50%, and 14.58%, respectively). In summer and fall, the MP infection rate was high (31.82% and 28.85%, respectively). In winter, the RSV infection rate (55.10%) was high. The proportion of children with mixed infections was relatively similar across the four seasons, with a relatively higher infection rate (17.31%) in autumn. Conclusion: Among the pathogens identified in children with acute lower respiratory tract infections admitted to Zhengzhou People’s Hospital from 2024 to 2026, RSV and MP were the primary pathogens. The incidence peaks of various respiratory pathogens varied according to the children’s age groups and seasons. Clinicians should conduct early pathogen identification based on actual conditions to guide the development of targeted treatment plans and improve patient outcomes.

急性心肌梗死患者PCI术后6个月内预后不良的影响因素分析及术前血清MPO、SAA、CK-MB水平联合检测对预后不良的预测效能

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目的 探讨急性心肌梗死(AMI)患者经皮冠状动脉介入(PCI)术后6个月内预后不良的影响因素及术前血清髓过氧化物酶(MPO)、淀粉样蛋白A(SAA)、肌酸激酶同工酶(CK-MB)水平联合检测对预后不良的预测效能。方法 前瞻性选取2023年1月~2025年1月许昌市人民医院诊治的204例AMI患者作为AMI组,另选取同期102例健康志愿者作为对照组。比较两组血清MPO、SAA、CK-MB水平。AMI组患者予以PCI术治疗,依据PCI术后6个月内(失访8例)预后情况将分为预后不良亚组(42例)和预后良好亚组(154例),比较不同预后AMI患者临床资料及术前血清MPO、SAA、CK-MB水平。分析AMI患者PCI术后6个月内预后不良的影响因素;分析术前血清MPO、SAA、CK-MB水平联合检测对预后不良的预测效能。结果 AMI组血清MPO、SAA、CK-MB水平高于对照组(P<0.05);预后不良亚组多支病变占比、Killip分级Ⅲ级占比、支架置入数、术前血清MPO、SAA、CK-MB水平高于预后良好亚组(P<0.05);校正病变支数、Killip分级、支架置入数后,术前血清MPO、SAA、CK-MB水平是AMI患者PCI术后6个月内预后不良的独立影响因素(P<0.05);术前血清MPO、SAA、CK-MB联合预测预后不良的AUC值明显高于各血清指标单度指标预测(P<0.05)。结论 AMI患者血清MPO、SAA、CK-MB水平明显升高,且是AMI患者PCI术后预后不良的独立影响因素,联合检测其水平对预后不良具有较高的预测效能。

急性中毒导致缺血缺氧性脑病患者预后的影响因素及预测模型研究

Study on the influencing factors and prediction model of prognosis in patients with hypoxic-ischemic encephalopathy caused by acute poisoning

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目的:分析急性有机磷农药中毒(AOPP)引发缺血缺氧性脑病预后相关因素,建立相关的预后预测模型。方法:回顾性分析90例(33例预后不良、57例预后良好)AOPP致HIE患者(2022年3月~2025年8月)的临床资料、中毒指标和血清学指标,独立危险因素用Logistic回顾分析筛选,并构建预后不良预测模型,采用ROC工具对模型效能进行验证。结果:Logistic 回归分析显示,年龄≥60岁、重度中毒、中毒至就诊时间、LAC水平、CHE水平、CRP水平及NSE水平均为患者预后不良的独立危险因素(P<0.05);AUC、灵敏度、特异度为0.943、90.91%、87.72%。结论:高龄、中毒程度高及中毒至就诊时间长等因素可导致AOPP致HIE患者出现不良结局,据此构建风险预测模型可有效预测预后不良的发生风险。
To determine the key impacting factors for hypoxic ischemic encephalopathy (HIE) caused by acute organophosphorus pesticide poisoning (AOPP) and build a prediction model. Methods: The clinical data, poisoning indicators and serological indicators of 90 patients (33 cases with poor prognosis and 57 cases with good prognosis) with HIE caused by AOPP (from March 2022 to Aug 2025) were analyzed. Independent risk factors were screened using logistic retrospective analysis, and a poor prognosis prediction model was constructed. The model efficiency was verified by the receiver operating curve (ROC). Results: Logistic regression analysis showed that age ≥ 60 years, severe poisoning, time from poisoning to treatment, LAC level, CHE level, CRP level, and NSE level were all risk factors for the prognosis in patients (P < 0.05). The AUC, sensitivity, and specificity were 0.943, 90.91%, and 87.72%.Conclusion: Factors such as advanced age, high degree of poisoning, and long time from poisoning to treatment can lead to adverse outcomes in patients with HIE caused by AOPP. Based on this, building a risk prediction model can effectively predict the risk of poor prognosis.

重症急性胰腺炎患者CRRT治疗期间液体平衡管理体验与需求研究

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摘要:目的 探讨重症急性胰腺炎患者在CRRT治疗期间液体平衡管理的体验与需求,为优化临床液体管理及护理支持策略提供依据。方法 采用描述性质性研究方法,运用目的抽样法选取2024年5月—2025年12月在我院重症医学科接受CRRT治疗的13例重症急性胰腺炎患者进行半结构式深入访谈。采用Colaizzi七步分析法对访谈资料进行整理、编码、归类与主题提炼。结果 本研究最终提炼出4个主题、11个亚主题,分别为:①强烈而持续的身体不适体验(强烈的口渴感、身体肿胀与沉重、治疗期间寒冷与束缚);②液体管理限制下的认知行为冲突(对限液医嘱情绪复杂、出入量监测引发的复杂感受、配合行为背后的动力与障碍);③治疗过程中的负性情绪与心理调适(治疗初期的强烈恐惧与不确定感、无助感与自主权被削弱、在病痛中重建希望与韧性);④对疾病信息与多维照护支持的迫切需求(信息缺乏引发困惑与焦虑、照护支持需求)。结论 重症急性胰腺炎患者在CRRT治疗期间,临床护理不仅应关注液体出入量等客观指标,还应重视患者的口渴等主观不适、限液过程中的认知行为冲突、治疗相关情绪反应及信息支持需求。

内镜逆行阑尾炎治疗术与腹腔镜阑尾切除术治疗急性化脓性阑尾炎的疗效对比

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目的 对比内镜逆行阑尾炎治疗术(ERAT)与腹腔镜阑尾切除术(LA)治疗急性化脓性阑尾炎(ASA)的效果。方法 按随机数字表法将2022年7月-2025年12月本院收治的106例SAS患者分为对照组(LA治疗)及观察组(ERAT治疗),各53例。比较两组围手术期指标、术后恢复指标、炎症因子水平[C反应蛋白(CRP)、白介素-6(IL-6)、降钙素原(PCT)]、疼痛介质水平[P物质(SP)、前列腺素E2(PGE2)、5-羟色胺(5-HT)]、免疫功能、胃肠激素[胃泌素(GAS)、血管活性肠肽(VIP)、胃动素(MTL)]、并发症、复发率。结果 观察组较对照组术中出血量更少,手术、住院时间与肛门排气、首次下床活动、体温复常及术后进食时间更短,并发症发生率更低;术后48h的CRP、IL-6、PCT、SP、PGE2、5-HT及VIP水平更低,CD3+、CD4+、CD4+/CD8+与GAS、MTL水平更高,有统计学差异(P<0.05);术后3个月内,两组均无1例复发。结论 与LA治疗ASA相比,ERAT具有创伤小、恢复快、炎症反应轻、并发症少等优势,且对免疫功能、胃肠功能影响小等优势,值得临床借鉴。

血清ALB、FIB、LDH联合检测对急性心肌梗死患者短期预后的预测价值分析

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目的 探讨血清白蛋白(ALB)、纤维蛋白原(FIB)、乳酸脱氢酶(LDH)水平联合检测对急性心肌梗死患者短期预后的预测价值,以期为临床早期制定相应干预方案、改善患者预后提供参考。 方法 回顾性选取我院2023年1月~2025年1月收治的132例急性心肌梗死患者,入院后均接受经皮冠脉介入术(PCI)术治疗,根据术后6个月是否发生心血管主要不良事件(MACE)分为预后不良组(n=34)、预后良好组(n=98),比较两组临床资料及入院时血清ALB、FIB、LDH水平,Logistic回归方程分析血清ALB、FIB、LDH水平与急性心肌梗死患者PCI术后预后的关系,受试者工作特征(ROC)曲线分析其预测价值。 结果 两组病变血管支数、Killip分级及入院时血清ALB、FIB、LDH水平比较,差异具有统计学意义(P<0.05);入院时血清ALB、FIB、LDH水平与PCI术后预后显著相关,均为其独立影响因素(P<0.05);绘制ROC曲线结果显示,入院时血清ALB、FIB、LDH对于PCI术后预后不良的预测AUC分别为0.795、0.856、0.832,联合预测预后不良的AUC为0.927(95%CI:0.892~0.963),大于各方案单独预测,敏感度为91.18%,特异度为89.80%;危险度分析显示,血清ALB低水平患者预后不良风险是高水平患者的6.127倍,血清FIB、LDH高水平患者预后不良风险是低水平患者的10.493、8.170倍(P<0.05)。 结论 血清ALB、FIB、LDH水平联合检测对急性心肌梗死患者PCI术后预后具有较高预测价值,临床可根据其早期评估患者预后不良风险,以制定个体化干预方案,改善患者预后。
论著

经颅多普勒超声参数联合屏气指数对 ICA 狭窄或闭塞所致急性脑梗死的评估价值

The evaluation value of transcranial Doppler ultrasound parameters combined with breath holding index for acute cerebral infarction caused by ICA stenosis or occlusion

:1724-1729
 
       目的   探讨经颅多普勒超声(TCD)参数联合屏气指数在颈内动脉(ICA)狭窄或闭塞所致急性脑梗死的评估价值。方法   选择2022年1月—2024年12月,在广州市花都区人民医院连续入组发病72 h内ICA狭窄或闭塞所致的急性脑梗死患者。记录患者人口统计学资料、临床资料及TCD相关参数,包括搏动指数(PI)、阻力指数( RI)、大脑中动脉平均血流速度(Vm)及屏气指数等。依据患者数字减影血管造影(DSA)结果分为侧支循环良好组及侧支循环不良组。比较两组人口统计学、临床资料及TCD相关参数,采用单因素分析、多因素Logistic回归分析及ROC曲线。结果   共纳入ICA狭窄或闭塞所致急性脑梗死共136例,其中侧支循环良好组46例,侧支循环不良组90例。单因素分析提示:侧支循环良好组与侧支循环不良组在PI[0.95(0.80,1.03)vs 1.01(0.88,1.13)]、RI[0.58(0.51,0.62)vs 0.60(0.54,0.65)]、Vm[57(44,65)vs 50.5(41,63)]及屏气指数[0.78(0.75,0.85)vs 0.72(0.59,0.79)]方面,差异具有统计学意义(P<0.05)。多因素Logistic回归分析提示Vm(OR=1.029,95%CI:1.006~1.053,P=0.014)、屏气指数(OR=723.401,95%CI:14.524~3 6031.859,P<0.001)是侧支循环不良的独立危险因素。屏气指数和Vm评估侧支循环情况的ROC曲线下面积(AUC)分别为0.713(95%CI:0.627~0.799)和0.605(0.505~0.705),两者的AUC值比较差异无统计学意义(P0.05)。结论   屏气指数和Vm可以评估ICA狭窄或闭塞所致急性脑梗死的侧支循环,屏气指数和Vm的评估效能相当。
       Objective  To explore the evaluation value of transcranial Doppler ultrasound(TCD)in acute cerebral infarction caused by internal carotid artery(ICA)stenosis or occlusion.Methods  From January 2022 to December 2024,patients with acute cerebral infarction caused by ICA stenosis or occlusion within 72 hours of onset were enrolled in our hospital.Patient’s demographic data,clinical data,and TCD related parameters,including pulsatility index(PI),resistance index(RI),average blood flow velocity(Vm)of the middle cerebral artery,and breath holding index(BHI)were recorded.According to the results of digital silhouette angiography(DSA),patients were divided into good collateral group and poor collateral group.Demographic,clinical data,and TCD related parameters were compared between two groups using univariate analysis,multivariate Logistic regression analysis and ROC curve.Results  A total of 136 cases of acute cerebral infarction caused by  ICA stenosis or occlusion were included,including 46 cases in the collateral good group and 90 cases in the collateral poor group.Univariate analysis showed that the good collateral group and the poor collateral group were different in PI(0.95[0.80,1.03]vs 1.01[0.88,1.13]),RI(0.58[0.51,0.62]vs 0.60[0.54,0.65]),Vm(57[44,65]vs 50.5[41,63]),BHI(0.78[0.75,0.85] vs 0.72[0.59,0.79])(P<0.05).Multivariate Logistic regression analysis showed that Vm(OR=1.029,95%CI:1.006-1.053,P=0.014)and BHI(OR=723.401,95%CI:14.524-36 031.859,P<0.001)were independent risk factors for collateral circulation disorders.The area under the ROC curve(AUC)for predicting collateral circulation using BHI and Vm were 0.713(95%CI0.627~0.799)and 0.605(0.505~0.705),respectively.There was no statistically significant difference in AUC values between the BHI and Vm.Conclusions  The BHI and Vm can predict the collateral circulation of acute cerebral infarction caused by ICA stenosis or occlusion,and their predictive power is comparable.
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