摘要
目的探讨不同严重程度的急性缺血性脑卒中(acute ischemic stroke,AIS)患者发生急性胃肠损伤(acute gastrointestinal injury,AGI)事件分级与短期预后的相关性。方法回顾性地入选2023年1—11月由广州中医药大学第八临床医学院高级卒中中心收治入院的AIS患者,并根据神经功能的缺损程度(NIHSS)将AIS患者分为NIHSS≤14分组与NIHSS>14分组,收集患者入院时的NIHSS评分、一般基线资料、入院时的临床检验指标、AGI事件分级和短期预后情况。结果共纳入270例患者,平均年龄为(64.95±13.65)岁,男性占70.0%,女性占30.0%。AIS患者发生AGI事件的比例占66.30%。AIS患者发生AGI事件后,起病后90 d改良Rankin评分量表(modified Rankin scale,mRS)mRS评分>2分的有83例,占30.7%;纳入的270例不同AGI事件分级的AIS患者间的不良临床结局有显著差异(P<0.05),其中AGI 0级、AGIⅠ级分别与AGIⅢ级、AGIⅣ级的不良临床结局有差异,AGIⅢ级、AGIⅣ级预后不良的发生率相较于AGI 0级、AGIⅠ级明显增高。在NIHSS>14分组的AIS患者中,AGI 0级、AGIⅠ级与AGIⅢ级的不良临床结局有差异(P<0.05),AGIⅢ级预后不良的发生率相较于AGI 0级、AGIⅠ级明显增高。多因素logistic回归分析显示,NIHSS评分是AIS患者发生AGI事件的独立危险因素(P<0.05),NIHSS评分越高则AIS患者发生AGI事件风险越大;且年龄、NIHSS评分、收缩压是影响AIS患者发生AGI事件后90 d预后不良的独立因素(P<0.05),年龄越大、NIHSS评分越高、收缩压越高的AIS患者在发生AGI事件后90 d预后不良的风险更高。结论不同严重程度的AIS患者发生AGI事件分级与短期预后相关。
Objective To explore the grading of acute gastrointestinal injury(AGI)events in patients with different severities of acute ischemic stroke(AIS)and correlation of short-term prognosis.Methods AIS patients admitted from the Advanced Stroke Center of the Eighth Clinical Medical College of Guangzhou University of Chinese Medicine from January 2023 to November 2023 were retrospectively selected,and depending on the degree of nerve function defect(NIHSS)scores.AIS patients were divided into two groups:NIHSS≤14 group and NIHSS>14 group.The National Institute of Health Stroke Scale(NIHSS)score,general baseline data,clinical test indicators,AGI event classification and short-term prognosis were collected at admission.Results A total of 270 patients were included,with an average age of(64.95±13.65)years,70.0%males and 30.0%females.The proportion of AIS patients with AGI incident accounted for 66.30%.AIS patients after AGI incidents,90 days after the onset of the modified Rankin rating scale(mRS)score>2 points of 83 people,accounting for 30.7%;The poor clinical outcomes of 270 AIS patients with different AGI event grades were significantly different(P<0.05),among which AGI grade 0 and AGI gradeⅠwere significantly different from AGI gradeⅢand AGI gradeⅣ,respectively.The incidence of poor prognosis of AGI gradeⅢand AGI gradeⅣis significantly higher than that of AGI grade 0 and AGI gradeⅠ.In AIS patients with NIHSS>14 group,there were significant differences in the adverse clinical outcomes between AGI grade 0,AGI gradeⅠand AGI gradeⅢ(P<0.05),and the incidence of poor prognosis of AGI gradeⅢwas significantly higher than that of AGI grade 0 and AGI gradeⅠ.Multivariate Logistic regression analysis showed that NIHSS score was an independent risk factor for AGI events in AIS patients(P<0.05).The higher the NIHSS score,the higher the risk of AGI events in AIS patients.And age,NIHSS score,systolic blood pressure is 90 days after AGI events affect AIS patients independent risk factors of poor prognosis(P<0.05),the higher the age,the greater the NIHSS score,the higher systolic blood pressure of patients with AIS 90 days after AGI events are at higher risk of poor prognosis.Conclusion AGI event grading in patients with AIS of different severity is associated with short-term prognosis.
作者
刘绍辉
吴曦
魏思源
吴智鑫
黄少娟
苏懿
李远艺
范文定
吴清玉
LIU Shaohui;WU Xi;WEI Siyuan;WU Zhixin;HUANG Shaojuan;SU Yi;LI Yuanyi;FAN Wending;WU Qingyu(The Eighth Clinical Medical College of Guangzhou University of Chinese Medicine,Foshan 528000,Guangdong,China;Neuro intensive care unit of Foshan Traditional Chinese Medicine Hospital,Foshan 528000,Guangdong,China)
出处
《实用医学杂志》
CAS
2024年第23期3323-3330,共8页
The Journal of Practical Medicine
基金
国家自然科学基金项目(编号:82374216)
广东省科学技术厅基础与应用基础研究基金项目(粤佛地区培育项目)(编号2022A1515140060)
广东省医学科研基金项目(编号:A2024130)
广东省中医药局科研项目(编号:20241307)
佛山市科学技术局自筹经费类科技创新项目(编号:2220001005576)
佛山市医学科研课题(编号:20240097)。
