摘要
目的:研究入院美国国立卫生研究院卒中量表(National Institutes of Health Stroke Scale,NIHSS)评分联合白细胞计数(White blood cell count,WBC)预测急性脑梗死(Acute Cerebral Infarction,ACI)患者静脉溶栓后早期神经功能恶化(Early Neurological Deterioration,END)发生风险的价值。方法:选取2021年6月至2024年9月期间本院收治的ACI患者105人作为研究对象。依据静脉溶栓后72 h内是否发生END,将患者分为非END组(n=78)和END组(n=27)。比较两组患者的基线资料,分析影响ACI患者静脉溶栓后发生END的危险因素。计算入院NIHSS评分、WBC对ACI患者静脉溶栓后END发生风险的预测效能。结果:两组的年龄、性别、吸烟、高血压、发病至溶栓时间、梗死部位、血小板计数、血红蛋白均无明显差异(P>0.05)。END组入院的NIHSS评分、WBC、急性卒中治疗Org 10172试验分型(Trial of Org 10172 in Acute Stroke Treatment Classification,TOAST)(大动脉粥样硬化型)、梗死面积(大面积梗死)占比均明显高于非END组(P<0.05)。采用多元Logistic回归,入院NIHSS评分、WBC升高、TOAST分型(大动脉粥样硬化型)、梗死面积(大面积梗死)为影响ACI患者静脉溶栓后发生END的危险因素(P<0.05)。绘制受试者工作特性(Receiver operating characteristic,ROC)曲线可知,入院NIHSS评分、WBC联合预测ACI患者静脉溶栓后END发生风险的敏感度和特异度均显著高于入院NIHSS评分、WBC单独检测(P<0.05)。结论:入院NIHSS评分、WBC升高是ACI患者静脉溶栓后发生END的危险因素,且两者联合检测对ACI患者静脉溶栓后END发生风险的预测价值相对更高。
Objective:Study admission National Institutes of Health Stroke Scale(NIHSS)score combined with white blood cell count(white blood cell count)(WBC)to predict the risk of Early Neurological Deterioration(END)after intravenous thrombolysis in patients with Acute Cerebral Infarction(ACI).Methods:A total of 105 patients with ACI admitted to our hospital from June 2021 to September 2024 were selected as the study subjects.According to whether END occurred within 72 hours after intravenous thrombolysis,105 patients were divided into non-END group(n=78,no END)and END group(n=27,END).The baseline data of the two groups were compared,and the risk factors affecting END after intravenous thrombolysis in ACI patients were analyzed.The predictive efficacy of admission NIHSS score and WBC on the risk of END after intravenous thrombolysis in ACI patients was calculated.Results:There was no significant difference in age,sex,smoking,hypertension,time from onset to thrombolysis,infarct location,platelet count and hemoglobin between the two groups(P>0.05).The NIHSS score,WBC,Trial of Org 10172 in Acute Stroke Treatment Classification(TOAST)(large artery atherosclerosis type)and infarct size(large area infarction)in the END group were significantly higher than those in the nonEND group(P<0.05).Multivariate Logistic regression was used to analyze the risk factors of END in ACI patients after intravenous thrombolysis,including NIHSS score,WBC increase,TOAST classification(large artery atherosclerosis type)and infarct size(large area infarction)(P<0.05).Receiver operating characteristic(ROC)curve showed that the sensitivity and specificity of admission NIHSS score combined with WBC in predicting the risk of END after intravenous thrombolysis in ACI patients were significantly higher than those of admission NIHSS score and WBC alone(P<0.05).Conclusion:Elevated NIHSS score and WBC are risk factors for END after intravenous thrombolysis in ACI patients,and the combined detection of NIHSS score and WBC is relatively higher in predicting the risk of END after intravenous thrombolysis in ACI patients.
作者
高明光
赵震
马磊
Gao Ming-guang;Zhao Zhen;Ma Lei(Department of Neurology,Ningling Hospital of Traditional Chinese Medicine,Shangqiu 476700,Henan,China)
关键词
NIHSS评分
白细胞计数
急性脑梗死
静脉溶栓
早期神经功能恶化
National Institutes of Health Stroke Scale Score
White blood cell count
Acute cerebral infarction
Intravenous thrombolysis
Early neurological deterioration
