【摘要】 目的 探究同型半胱氨酸(Hcy)、低密度脂蛋白胆固醇(LDL)、超敏-C反应蛋白(hs-CRP)与老年急性缺血性脑卒中(AIS)静脉溶栓预后相关性。方法 选择蚌埠医科大学附属蚌埠市第三人民医院神经内科2022年1月至2023年12月收治200例老年AIS患者,患者均行静脉溶栓治疗,在治疗后24h测定血清Hcy、LDL、hs-CRP,在患者溶栓治疗90 d时行改良Rankin评分(mRS)评估,依据mRS评分将<2分与≥2分的患者分为预后良好组与预后不良组,比较两组患者血清Hcy、LDL、hs-CRP,分析血清Hcy、LDL、hs-CRP与mRS评分相关性,血清Hcy、LDL、hs-CRP对患者预后预测价值,以及影响患者预后危险因素。结果 预后良好组患者血清Hcy、LDL、hs-CRP水平低于预后不良患者(P<0.05);Pearson相关性分析显示,血清Hcy、LDL、hs-CRP水平与mRS评分呈正相关关系(r=0.613,0.753,0.482;P<0.05);受试者工作曲线显示,血清Hcy、LDL、hs-CRP用于预测患者预后曲线下面积值分别为0.693、0.758、0.796;单因素与多元Logistic回归分析,结果显示入组时美国国立卫生研究卒中量表(NIHSS)评分、起病到溶栓治疗时间及血清Hcy、LDL、hs-CRP为患者预后影响因素(P<0.05)。结论 老年AIS患者血清Hcy、LDL、hs-CRP水平与患者预后关系密切,三指标用于预测患者预后有一定价值,可以作为患者预后评估潜在指标。。更多还原

【Abstract】 Objective To explore the correlation among homocysteine(Hcy),low-density lipoprotein(LDL) cholesterol,hypersensitive C-reactive protein(hs-CRP) and prognosis of elderly patients with acute ischemic stroke(AIS).Methods 200 elderly patients with AIS admitted to Department of Neurology,Bengbu Third People’s Hospital Affiliated to Bengbu Medical University from January 2022 to December 2023 were chosen.All patients received intravenous thrombolytic therapy.Serum Hcy,LDL and hs-CRP were measured at 24 h after treatment,and modified Rankin score(mRS) was evaluated at 90 d after thrombolytic therapy.Patients were separated into good prognosis group(lower than 2 points) and poor prognosis group(higher or equal to 2 points) and by mRS score.Serum Hcy,LDL,hs-CRP of patients were compared,and the correlation among serum Hcy,LDL,hs-CRP and mRS Score was analyzed.The prognostic value of serum Hcy,LDL and hs-CRP in patients was analyzed,and the risk factors affecting the prognosis of patients were analyzed.Results The levels of serum Hcy,LDL and hs-CRP in the good prognosis group were lower than those in the poor prognosis group(P <0.05),Pearson correlation analysis showed that serum Hcy,LDL,hs-CRP levels were positively correlated with mRS Scores(r=0.613,0.753,0.482;P <0.05),The area under the curve values of serum Hcy,LDL and hs-CRP for predicting prognosis were 0.693,0.758 and0.796,respectively.Through univariate and multiple Logistic regression analysis,NIHSS score,onset to thrombolytic therapy time,serum Hcy,LDL and hs-CRP were influencing factors for prognosis(P <0.05).Conclusions The serum levels of Hcy,LDL and hs-CRP in elderly patients with AIS are closely related to the prognosis of patients.These three indicators have certain value in predicting the prognosis,and can be used as potential indicators to evaluate the prognosis.更多还原