摘要
目的探讨急性出血性脑卒中患者早期系统免疫炎症指数(SII)及C反应蛋白(CRP)在不同时间点的动态变化及与预后的相关性。方法选取2021年1月1日—2023年2月28日由武汉市第三医院急诊科收治入院的急性出血性脑卒中患者169例。收集患者住院期间基本临床资料,动态收集在入院时(发病24 h内)、入院治疗24~48 h、入院治疗5~7 d检测的CRP及中性粒细胞绝对值、淋巴细胞绝对值、血小板计数,并计算系统免疫炎症指数SII;根据出院时的改良Rankin评分量表(mRS评分)评估患者短期预后水平,分为预后良好组(mRS≤2分)和预后不良组(mRS>2分),比较不同组别在不同时间点SII及CRP的变化特点,利用受试者工作特征(ROC)曲线及曲线下面积(AUC)分析其与急性出血性脑卒中预后的相关性。结果不同时间点的SII及CRP均有统计学意义(P<0.000),SII水平随时间变化先增加后下降,CRP水平随时间增加;不同组别的SII及CRP均有统计学意义(P<0.000),预后不良组高于预后良好组。SII及CRP水平与急性出血性脑卒中患者预后不良呈正相关(P<0.05)。入院24~48 h及入院5~7 d的SII联合CRP指标对预后不良有预测价值。结论在急性出血性脑卒中患者发病后,SII呈现先升高后降低的变化趋势,CRP呈现不断升高的变化趋势,入院24~48 h及入院5~7 d的SII及CRP水平与急性出血性脑卒中预后相关,入院5~7 d时对预后不良预测价值较高,临床或可通过此指标来预测急性出血性脑卒中患者短期预后情况。
Objective To investigate the dynamic changes of systemic immune inflammatory index(SII)and Creactiveprotein(CRP)in patients with acute hemorrhagic stroke at different time points and its correlation with prognosis.Methods A total of 169 acute hemorrhagic stroke patients with acute hemorrhagic stroke admitted to the emergency department of Wuhan Third Hospital from January 1,2021 to February 28,2023 were enrolled.Basic clinical data were collected during hospitalization,and CRP,and absolute neutrophil,absolute lymphocyte,and platelet counts were dynamically collected at admission(within 24 h of onset),24-48 h of admission,and 5-7 days of admission,and SII was calculated;the short-term prognostic level of patients was assessed according to the modified Rankin Scale(mRS)score at discharge and divided into the good prognosis group(mRS≤2 points)and poor prognosis group(mRS>2 points).The characteristics of SII and CRP in different groups at different time points were compared,and the clinical predictive significance of SII on the prognosis of acute hemorrhagic stroke was analyzed using the working characteristic curve(ROC)and area under the curve of the subjects(AUC).Results SII and CRP at different time points was statistically significant(P<0.000),SII increased and then decreased with time,and CRP increased with time;SII and CRP in different groups was statistically significant(P<0.000),and the poor prognosis group was higher than the good prognosis group.SII and CRP levels were positively correlated with poor prognosis in patients with acute hemorrhagic stroke(P<0.05).The SII combined CRP index at 24-48 hours and 5-7 days of admission had predictive value for poor prognosis.Conclusion After the onset of acute hemorrhagic stroke patients,SII showed a trend of increasing and then decreasing,and CRP showed a trend of increasing,the levels of SII and CRP at 24-48 hours and 5-7 days of admission are associated with the prognosis of acute hemorrhagic stroke,and the predictive value was higher at 5-7 days of admission,and the short-term prognosis of patients with acute hemorrhagic stroke could be predicted clinically by this index.
作者
高馨
付守芝
杨璐瑜
陆辉志
曹松
GAO Xin;FU Shouzhi;YANG Luyu;LU Huizhi;CAO Song(Medical College,Wuhan University of Science and Technology,Wuhan Hubei 430065,China)
出处
《中国急救复苏与灾害医学杂志》
2023年第12期1585-1589,共5页
China Journal of Emergency Resuscitation and Disaster Medicine
基金
湖北省卫生健康委研究项目(编号:HBJG-220057)。
