摘要
目的 探讨血清前清蛋白（PA）水平对首发急性脑梗死患者短期预后的影响.方法 选取2010年1月-2013年7月在广州医科大学附属第二医院就诊的首发急性脑梗死患者345例,根据出院时改良Rankin量表（mRS）评分,将患者分为预后良好组（mRS评分0~2分,223例）和预后不良组（mRS评分3～6分,122例）.比较两组患者的临床资料及血清PA水平.采用SPSS 13.0统计学软件进行统计检验.结果 预后不良组患者起病年龄及2型糖尿病、缺血性心脏病、完全前循环梗死（TACI）的患病率均高于预后良好组,而血清PA水平[（192±58）mg/L]则低于预后良好组[（216±57）mg/L]（P＜0.05）.按血清PA四分位数截取点169、207、245 mg/L将患者分为4组,第一、二、三、四分位数组患者出院时mRS评分分别为2.5（2.0）、2.0（2.0）、1.0（2.0）、1.0（3.0）分,差异有统计学意义（P＜0.001）.多因素Logistic回归分析显示：高龄（OR=1.028,P=0.007）、2型糖尿病（OR=2.391,P=0.004）、缺血性心脏病（OR=2.308,P=0.022）和TACI（OR=17.625,P＜0.001）是患者预后不良的独立危险因素,而急性期血清PA水平升高（OR=0.994,P=0.008）则是患者预后不良的独立保护因素.结论 血清PA水平升高是首发急性脑梗死患者短期预后的独立保护因素.
Objective To explore the impacts of prealbumin（PA） on short-term prognosis in patients with first acute cerebral infarction.Methods A total of 345 first acute cerebral infarction patients who were treated in the Second Affiliated Hospital of Guangzhou Medical University from January 2010 to July 2013,were divided into with good outcome group（mRS score：0-2,223 cases） and without good outcome group（mRS score：3-6,122 cases） according to mRS score at the time of hospital discharge.Clinical features and serum PA level were compared between two groups.SPSS version 13.0 statistical software was used for statistics.Results The age of onset,the prevalences of type 2 diabetes mellitus,ischemic heart disease and total anterior circulation infarcts（TACI） in without good outcome group were significantly higher than those in good outcome group,but the level of serum PA in without good outcome group was significantly lower than that in good outcome group[（192±58）mg/L vs.（216±57）mg/L;P〈0.05].The patients were divided into 4 groups according to quartile intercept point of serum PA level（169,207 and 245 mg/L）,mRS score of 4 groups at the time of hospital discharge was 2.5（2.0）,2.0（2.0）,1.0（2.0） and 1.0（3.0）respectively,the difference was statistically significant（P〈0.001）.According to the results of Logistic regression analysis,advanced age,type 2 diabetes mellitus,ischemic heart disease,and TACI were independent risk factors for the poor outcome,and the OR values was 1.028（P=0.007）,2.391（P=0.004）,2.308（P=0.022） and 17.625（P〈0.001） respectively.The high level of serum PA in the acute phase was the independent protective factor for the bad outcome,and the OR value was 0.994（ P=0.008）.Conclusion The high level of serum PA in the acute phase is the independent protective factor for good short-term prognosis in first acute cerebral infarction patients.
出处
《中国全科医学》
CAS
CSCD
北大核心
2014年第9期989-992,共4页
Chinese General Practice
基金
广东省科技计划项目(2011B061300004)
关键词
脑梗死
前清蛋白
预后
危险因素
Brain infarction
Prealbumin
Prognosis
Risk factors
