摘要
目的探讨颈动脉超声参数联合血小板-白细胞聚集体(PLA)对大面积脑梗死患者预后的预测价值。方法选取155例大面积脑梗死患者,根据改良Rankin量表(mRs)评分分为预后不良组(>2分)和预后良好组(≤2分)。比较两组一般临床资料、颈动脉超声参数[内膜中膜厚度(IMT)、颈内动脉收缩期峰值速度(PSV)、舒张末期速度(EDV)]及PLA。采用多因素Logistic回归分析预后的影响因素,采用ROC曲线分析各指标对预后的预测价值。结果预后不良组NIHSS评分、发病至入院时间12~24 h占比、心房颤动占比高于预后良好组(P<0.05)。预后不良组PSV低于预后不良组,EDV、IMT及PLA高于预后不良组(P<0.05)。多因素Logistic回归分析结果显示,PSV、EDV、IMT及PLA均是大面积脑梗死患者预后的主要危险因素(P<0.05)。颈动脉超声参数联合PLA预测大面积脑梗死患者预后的AUC高于各指标单独预测(P<0.05)。结论颈动脉超声参数联合PLA值检测对大面积脑梗死患者的预后具有较高的预测价值,值得临床应用及推广。
Aim To investigate the predictive value of carotid ultrasound parameters combined with platelet-leukocyte aggregates(PLA)for the prognosis of patients with large-area cerebral infarction.Methods A total of 155 patients with large-area cerebral infarction were enrolled and divided into a poor prognosis group(modified Rankin scale(mRS)score>2)and a good prognosis group(mRS score≤2).General clinical data,carotid ultrasound parameters(intima-media thickness(IMT),peak systolic velocity(PSV)of the internal carotid artery,end-diastolic velocity(EDV)),and PLA levels were compared between the two groups.Multivariate Logistic regression analysis was performed to identify factors influencing prognosis,and receiver operating characteristic(ROC)curve analysis was used to evaluate the predictive value of each indicator.Results The poor prognosis group had higher national institutes of health stroke scale(NIHSS)scores,a higher proportion of patients with an onset-to-admission time of 12-24 h,and a higher prevalence of atrial fibrillation compared to the good prognosis group(P<0.05).The poor prognosis group exhibited lower PSV values but higher EDV,IMT values,and elevated PLA levels than the good prognosis group(P<0.05).Multivariate L ogistic regression analysis revealed that PSV,EDV,IMT,and PLA were independent risk factors for poor prognosis in large-area cerebral infarction(P<0.05).The area under the curve(AUC)for the combination of carotid ultrasound parameters and PLA in predicting prognosis was significantly higher than that of each individual parameter(P<0.05).Conclusion The combination of carotid ultrasound parameters and PLA levels provides high predictive value for the prognosis of patients with large-area cerebral infarction,making it clinically valuable for application and promotion.
作者
惠培育
田治军
贺欢
HUI Peiyu;TIAN Zhijun;HE Huan(Department of Ultrasound,Xijing Hospital,Air Force Medical University,Xi an 710032,Shaanxi,China;Ultrasound Diagnosis Center,Ankang Gaoxin Hospital,Ankang 725000,Shaanxi,China;Cervical Spine Ward,Department of Spinal Surgery,Xi an Honghui Hospital,Xi an 710000,Shaanxi,China)
出处
《中南医学科学杂志》
2025年第5期871-874,共4页
Medical Science Journal of Central South China
基金
西京医院学科助推计划自由探索项目(XJZT18ML17)。
关键词
颈动脉超声参数
PLA
大面积脑梗死
预后
预测价值
carotid ultrasound parameters
PLA
large-area cerebral infarction
prognosis
predictive value
