摘要
目的探讨C反应蛋白(CRP)、全身免疫炎症指数(SⅡ)对非老年动脉瘤性蛛网膜下腔出血(aSAH)患者的预后价值。方法收集2021年7月至2023年4月郑州大学第五附属医院住院的108例aSAH患者的临床资料,根据出院3个月的改良Rankin量表(mRS)评分标准将患者分为预后良好组(mRS 0~2分)和预后不良组(mRS 3~6分),比较两组患者的临床资料,分析预后不良的独立影响因素,并绘制受试者工作特征(ROC)曲线评估不同独立影响因素对患者预后不良的预测价值。结果108例非老年aSAH患者中预后不良组48例,预后良好组60例。单因素分析结果显示,两组患者在Fisher分级、Hunt-Hess分级、CRP、白细胞计数、淋巴细胞计数、中性粒细胞计数、SⅡ方面差异均有统计学意义(P<0.05)。多因素logistic回归分析结果显示,Fisher分级、CRP、SⅡ是非老年aSAH患者预后不良的独立影响因素。ROC曲线分析结果显示CRP与SⅡ预测非老年aSAH患者预后不良的敏感度、特异度、曲线下面积(AUC)分别为99.9%、60.0%、0.874和95.8%、63.3%、0.881,二者联合预测非老年aSAH患者预后不良的敏感度、特异度、AUC分别为72.9%、95.0%、0.911。结论升高的CRP与SⅡ是非老年aSAH患者预后不良的重要指标,二者联合的预测价值最高。
Objective To investigate prognostic value of C-reactive protein(CRP)and systemic immune inflammation index(SⅡ)for neurological outcome in non-older patients with aneurysmal subarachnoid hemorrhage(aSAH).Methods The clinical data of 108 aSAH patients hospitalized the Fifth Affiliated Hospital of Zhengzhou University were collected from July 2021 to April 2023.According to the modified Rankin scale(mRS)score at 3 months,the datas were divided into favorable(mRS,0 to 2 score)and unfavorable outcome(mRS,3 to 6 score).The characteristics were compared between aSAH patients with favorable and unfavorable outcome.In addition,receiver operating characteristic(ROC)curves were undertaken to evaluate the predictive value of different independent influencing factors in patients with aSAH.Results A total of 108 patients with aSAH were enrolled,including 48 patients with favorable and 60 patients with unfavorable outcome.Univariate analysis showed statistically differences between the two groups in terms of Fisher grade,Hunt-Hess grade,white blood cell count,neutrophil count,lymphocyte count,CRP,and SⅡ(P<0.05).In multivariate logistic regression analysis,it exhibited that Fisher grade,CRP,SⅡwere independent predictors in non-old aSAH patients.ROC curve analysis showed that the area under the curve(AUC),sensitivity and specificity of CRP and SⅡin predicting poor prognosis of non-elderly aSAH patients were 0.874,99.9%,60.0%and 0.881,95.8%,63.3%,respectively.The AUC,sensitivity and specificity of the combined prediction of poor prognosis in non-elderly aSAH patients were 0.911,72.9%and 95.0%,respectively.Conclusion Early elevated CRP and SⅡare the significant indicators of unfavorable outcome in non-old aSAH patients,and the combination has the highest predictive value.
作者
张娆娆
郭科航
卜克
王璐
徐瑞华
王明珠
丁一芮
段文文
刘贤良
翟萌萌
张强
郑亚绘
秦超
ZHANG Raorao;GUO Kehang;BO Ke;WANG Lu;XU Ruihua;WANG Mingzhu;DING Yirui;DUAN Wenwen;LIU Xianiang;ZHAI Mengmeng;ZHANG Qiang;ZHENG Yahui;QIN Chao(Department of Critical Care Medicine,the Fifth Affiliated Hospital of Zhengzhou University,Zhengzhou 450052,China)
出处
《河南医学研究》
CAS
2024年第2期209-214,共6页
Henan Medical Research
基金
河南省医学科技攻关计划联合共建项目(LHGJ20200483)。
