摘要
目的研究改良危重症营养风险评分(mNUTRIC)对重症脑梗死患者预后的预测价值。方法以2019年1月~2021年6月在华北理工大学附属医院神经内科住院的120例重症脑梗死患者为研究对象,依据1个月预后分为死亡组与存活组。比较两组患者一般资料与临床数据、入院24h内的mNUTRIC评分。通过多因素Logistic回归分析评估死亡的危险因素,比较mNUTRIC评分不同危险分层病死率、机械通气情况等差异,采用ROC曲线评估mNUTRIC评分对重症脑梗死患者预后的预测效能。结果120例患者中41例mNUTRIC评分≥5分,存在高营养风险;79例<5分,存在低营养风险。高营养风险组1个月病死率显著高于低营养风险组(41.46%:11.39%),差异有统计学意义(P<0.05);高营养风险组机械通气率高于低营养风险组(46.34%:35.44%),但差异无统计学意义(P>0.05)。120例中存活94例(78.33%)为存活组,死亡26例(21.67%)为死亡组。两组在高血压病史、序贯器官衰竭评分(SOFA)、mNUTRIC评分、mNUTRIC高营养风险、机械通气比较,差异有统计学意义(P<0.05)。多因素Logistic回归显示,高血压病史、mNUTRIC评分、机械通气是重症脑梗死患者死亡的独立影响因素(OR=6.695、P=0.027,OR=3.943、P=0.000,OR=6.697、P=0.015)。mNUTRIC评分预测重症脑梗死患者死亡的曲线下面积为0.912,敏感度为84.6%,特异度为89.4%。结论mNUTRIC评分是重症脑梗死患者预后的独立危险因素,可以预测其死亡风险。根据mNUTRIC评分对重症脑梗死患者进行营养风险分层,有助于指导治疗,改善预后。
Objective To study the predictive value of modified nutrition risk in Critically ill(mNUTRIC)score for prognosis of patients with severe cerebral infarction.Methods 120 patients with severe cerebral infarction who were hospitalized in the Department of Neurology,Affiliated Hospital of North China University of Science and Technology from January 2019 to June 2021 were selected as the research subjects.According to the 1-month prognosis,the patients were divided into the death group and the survival group.The general information and clinical data of the two groups were compared,and the mNUTRIC score within 24 hours after admission was compared.Multivariate logistic regression analysis was used to evaluate the risk factors of death,and the differences of mNUTRIC score in mortality and mechanical ventilation of different risk levels were compared.ROC curve was used to evaluate the predictive efficacy of mNUTRIC score for the prognosis of patients with se-vere cerebral infarction.Results 41 of the 120 patients had mNUTRIC score≥5,indicating high nu-tritional risk;79 patients with<5 points had low nutritional risk.The 1-month mortality in the high nutritional risk group was significantly higher than that in the low nutritional risk group(41.46%:11.39%),There were significant differences(P<0.05);The rate of mechanical ventilation in the high nutritional risk group was higher than that in the low nutritional risk group(46.34%:35.44%),and the difference was not statistically significant(P>0.05).94 patients(78.33%)were in the survival group,and 26 patients(21.67%)were in the death group.There were significant differences in hy-pertension history,SOFA score,mNUTRIC score,mNUTRIC nutritional risk and mechanical venti-lation between the two groups(P<0.05).Multivariate Logistic regression showed that history of hy-pertension,mNUTRIC score and mechanical ventilation were independent influencing factors of death(OR=6.695,P=0.027,OR=3.943,P=0.000,OR=6.697,P=0.015).mNUTRIC score predic-ted death of patients with severe cerebral infarction with 0.912 area under the curve,84.6%sensitivi-ty and 89.4%specificity.Conclusion mNUTRIC score is an independent prognostic risk factor for se-vere cerebral infarction,and can predict the mortality of patients with severe cerebral infarction.Nutri-tional risk stratification for patients with severe cerebral infarction based on mNUTRIC score is helpful to guide treatment and improve prognosis.
作者
苏相莹
石秋艳
沈晶
翟昊源
Su Xiangying;Shi Qiuyan;Shen Jing(Deparment of Neurology,Affiliated Hospital of North China Uni-versity of Science and Technology,Tangshan 063000,China)
出处
《华北理工大学学报（医学版）》
2022年第4期282-287,共6页
Journal of North China University of Science and Technology：Health Sciences Edition
关键词
改良危重症营养风险评分
重症脑梗死
预后
Modified nutrition risk in critically ill score
Severe cerebral infarction
The progno-sis
