摘要
目的探讨系统性免疫炎症指数(SII)和D-二聚体(D-dimer,D-D)对急性重度一氧化碳中毒(ASCMP)患者并发脑梗死(cerebral infarction,CI)的预测价值及对患者病情严重程度的评估作用。方法选择2015年1月至2023年1月作者医院收治的ASCMP患者共502例,根据入院后是否并发CI将患者分为并发CI组(n=46)和未并发CI组(n=456),比较并发CI组和未并发CI组临床资料的差异。根据美国国立卫生研究院卒中量表(NIHSS)评分将ASCMP并发CI患者分为轻型组17例,中型组14例,重型组15例,比较不同病情严重程度组间SII、D-D、中性粒细胞/淋巴细胞(NLR)和血小板/淋巴细胞(PLR)水平的差异。采用Pearson相关检验分析ASCMP并发CI患者SII和D-D与NIHSS评分的相关性。采用受试者工作特征(ROC)曲线分析SII、D-D及两者联合对ASCMP患者发生CI的预测价值。结果并发CI组患者SII、D-D、NLR和PLR水平高于未并发CI组(P<0.05);不同严重程度ASCMP并发CI患者组间SII、D-D、NLR和PLR比较均有统计学差异(P<0.05),且随病情严重程度加重,患者SII、D-D、NLR、PLR逐渐升高(P<0.05)。ASCMP并发CI患者SII和D-D与NIHSS评分呈正相关(r=0.826,P<0.01;r=0.809,P<0.01);SII、D-D及两者联合诊断ASCMP患者并发CI的ROC曲线下面积(AUC)分别为0.800、0.734和0.848,灵敏度分别为0.804、0.824、0.853,特异度分别为0.800、0.720、0.820。结论SII、D-二聚体对早期预测ASCMP发生CI及其严重程度有较高的临床价值,两者联合效果更佳。
Objective To explore the predictive value and the role of disease assessment of systemic immune inflammatory index(SII)and D-dimer(D-D)in patients with acute severe carbon monoxide poisoning(ASCMP)complicated with cerebral infarction(CI).Methods A total of 502 ASCMP patients admitted to the authors'hospital from January 2015 to January 2023 were selected,and they were divided into CI group(n=46)and non-CI group(n=456)according to whether they were complicated with CI after admission.The differences of clinical data between the group with CI and without CI were compared.According to the National Institutes of Health Stroke Scale(NIHSS)score,ASCMP patients complicated with CI were divided into mild group(n=17),medium group(n=14),and severe group(n=15).The changes of SII,D-D,neutrophil/lymphocyte(NLR),and platelet/lymphocyte(PLR)levels were detected among different severity groups.Pearson correlation test was used to analyze the correlation between SII,D-D,and NIHSS score in patients with ASCMP complicated with CI.The receiver operating characteristic(ROC)curve was drawn to analyze the predictive value of SII,D-D,and their combination for the occurrence of CI in ASCMP patients.Results The levels of SII,D-D,NLR,and PLR in patients with CI were higher than those in patients without CI(P<0.05).There were statistical differences in SII,D-D,NLR,and PLR between different severity groups(P<0.05).As the disease progressed,the levels of SII,D-D,NLR,and PLR of patients increased gradually(P<0.05).SII and D-D were positively correlated with NIHSS score in ASCMP patients complicated with CI(r=0.826,P<0.01;r=0.809,P<0.01).The area under ROC curve(AUC)of SII,D-D,and their combination in diagnosing ASCMP patients complicated with CI were 0.800,0.734 and 0.848,respectively,with sensitivity of 0.804,0.824 and 0.853,and specificity of 0.800,0.720 and 0.820,respectively.Conclusions SII and D-dimer have high clinical value in early predicting the occurrence and severity of CI in ASCMP,and the effect of their combination is better.
作者
杜月茹
齐洪娜
王园园
宫平
肖青勉
王维展
DU Yueru;QI Hongna;WANG Yuanyuan;GONG Ping;XIAO Qingmian;WANG Weizhan(不详;Emergency Department,Harrison International Peace Hospital Affiliated to Hebei Medical University,Hengshui 053000,China)
出处
《中国神经免疫学和神经病学杂志》
CAS
北大核心
2023年第5期326-330,共5页
Chinese Journal of Neuroimmunology and Neurology
基金
衡水市科学技术研究与发展计划项目(2021014077Z)。
