摘要
目的:探讨全身炎症反应指数(SIRI)联合血糖/血钾比值对动脉瘤性蛛网膜下腔出血(aSAH)患者预后不良的预测作用。方法:回顾性分析笔者所在医院2019年9月-2021年3月收治的135例aSAH患者的临床资料。根据出院3个月后的格拉斯哥预后(GOS)评分将其分为预后良好组(n=92)和预后不良组(n=43)。采用多因素Logistic回归分析aSAH患者预后不良的影响因素。绘制受试者工作特征(ROC)曲线,分析SIRI、血糖/血钾比值对aSAH患者预后不良的预测作用。结果:两组Hunt-Hess分级、改良Fisher分级、中性粒细胞计数、单核细胞计数、SIRI、血糖、血钾、血糖/血钾比值、急性脑积水(AHC)、肺炎、延迟性脑缺血(DCI)发生率比较差异有统计学意义(P<0.05)。多因素Logistic回归分析显示,Hunt-Hess分级、中性粒细胞计数、SIRI、血糖、血钾、血糖/血钾比值、DCI是aSAH患者预后不良的独立影响因素(P<0.05)。ROC曲线分析显示,SIRI和血糖/血钾比值预测aSAH患者预后不良的最佳临界值分别为5.91×109/L、1.96,曲线下面积(AUC)分别为0.769、0.757,敏感度分别为74.4%、72.1%,特异度分别为71.7%、59.8%。二者联合预测aSAH患者预后不良的AUC、敏感度、特异度分别为0.908、90.7%、73.9%。结论:SIRI、血糖/血钾比值与aSAH患者的预后不良有关,可以预测aSAH患者的预后不良,且SIRI联合血糖/血钾比值的预测价值较高,可以在临床上推广使用。
Objective:To investigate the predictive effect of systemic inflammation response index(SIRI)and blood glucose/blood potassium ratio on poor prognosis of patients with aneurysmal subarachnoid hemorrhage(aSAH).Method:The clinical data of 135 aSAH patients admitted in our hospital from September 2019 to March 2021 were retrospectively analyzed.They were divided into the good prognosis group(n=92)and the poor prognosis group(n=43)according to the Glasgow outcome(GOS)score at 3 months after discharge.Multivariate Logistic regression was used to analyze the influencing factors of poor prognosis of aSAH patients.Receiver operating characteristic(ROC)curve was drawn to analyze the predictive effect of SIRI and blood glucose/blood potassium ratio on the poor prognosis of aSAH patients.Result:There were statistically significant differences in Hunt-Hess grade,modified Fisher grade,neutrophil count,monocyte count,SIRI,blood glucose,blood potassium,blood glucose/blood potassium ratio,incidence of acute hydrocephalus(AHC),pneumonia and delayed cerebral ischemia(DCI)between the two groups(P<0.05).Multivariate Logistic regression analysis showed that Hunt-Hess grade,neutrophil count,SIRI,blood glucose,blood potassium,blood glucose/blood potassium ratio,and DCI were independent influencing factors for poor prognosis of aSAH patients(P<0.05).ROC curve analysis showed that the optimal critical values of SIRI and blood glucose/blood potassium ratio to predict the poor prognosis of aSAH patients were 5.91×10;/L and 1.96 respectively,the area under curve(AUC)was 0.769 and 0.757 respectively,the sensitivity were 74.4%and 72.1%respectively,and the specificity were 71.7%and 59.8%respectively.The AUC,sensitivity and specificity of the combined prediction of poor prognosis of aSAH patients were 0.908,90.7%and 73.9%,respectively.Conclusion:SIRI and blood glucose/blood potassium ratio are associated with poor prognosis of patients with aSAH,which can predict the poor prognosis of aSAH patients.In addition,The predictive value of SIRI combined with blood glucose/blood potassium ratio is high,which can be popularized in clinical application.
作者
史祥玉
彭慧平
SHI Xiangyu;PENG Huiping(Fujian University of Traditional Chinese Medicine,Fuzhou 350100,China;不详)
出处
《中外医学研究》
2021年第30期5-9,共5页
CHINESE AND FOREIGN MEDICAL RESEARCH
关键词
动脉瘤性蛛网膜下腔出血
全身炎症反应指数
血糖/
血钾
预后不良
Aneurysmal subarachnoid hemorrhage
Systemic inflammation response index
Blood glucose/blood potassium ratio
Poor prognosis
