CAJ | 학술논문

目的：探讨急性脑梗死90 d 预后相关的影响因素及急性期碱性磷酸酶(ALP)水平是否为急性脑梗死预后的独立危险因子。方法收集2013年9月~2014年2月于中国医科大学附属盛京医院神经内科住院治疗的急性脑梗死患者210例,全面收集与预后有关的临床资料并进行 NIHSS 量表评分,并于90 d后行短期预后随访,进行 mRS 量表评分；将 mRS 评分>2分定义为预后不良组,≤2分定义为预后良好组,对2组所收集资料进行统计分析。结果210例患者进入研究队列,90 d 后失访11例,失访率为5.24%,最终进入研究队列的患者为199例,其中47例(23.62%)发生预后不良事件。入院时 NIHSS 评分(P =0.001)、心房颤动病史(P =0.003)、碱性磷酸酶(P =0.001)、尿酸(P =0.027)以及超敏 C 反应蛋白(P =0.001)为急性脑梗塞90 d 预后的影响因素。入院时 NIHSS 评分(P =0.001,OR=1.46,95%CI =1.24~1.71)、碱性磷酸酶(P =0.001,OR=1.13,95%CI =1.09~ 1.18)为脑梗死预后的独立危险因子。结论入院时 NIHSS 评分、心房颤动病史、碱性磷酸酶、尿酸以及超敏 C 反应蛋白为急性脑梗塞90天预后的影响因素；NIHSS 评分和急性期碱性磷酸酶水平为脑梗死患者90 d 预后的独立危险因子。
목적：탐토급성뇌경사90 d 예후상관적영향인소급급성기감성린산매(ALP)수평시부위급성뇌경사예후적독립위험인자。방법수집2013년9월~2014년2월우중국의과대학부속성경의원신경내과주원치료적급성뇌경사환자210례,전면수집여예후유관적림상자료병진행 NIHSS 량표평분,병우90 d후행단기예후수방,진행 mRS 량표평분；장 mRS 평분>2분정의위예후불량조,≤2분정의위예후량호조,대2조소수집자료진행통계분석。결과210례환자진입연구대렬,90 d 후실방11례,실방솔위5.24%,최종진입연구대렬적환자위199례,기중47례(23.62%)발생예후불량사건。입원시 NIHSS 평분(P =0.001)、심방전동병사(P =0.003)、감성린산매(P =0.001)、뇨산(P =0.027)이급초민 C 반응단백(P =0.001)위급성뇌경새90 d 예후적영향인소。입원시 NIHSS 평분(P =0.001,OR=1.46,95%CI =1.24~1.71)、감성린산매(P =0.001,OR=1.13,95%CI =1.09~ 1.18)위뇌경사예후적독립위험인자。결론입원시 NIHSS 평분、심방전동병사、감성린산매、뇨산이급초민 C 반응단백위급성뇌경새90천예후적영향인소；NIHSS 평분화급성기감성린산매수평위뇌경사환자90 d 예후적독립위험인자。
Objective To investigate factors that affect the 90 day prognosis of acute stroke patients, and whether serum alkaline phosphatase level in acute stage is an independent risk factor for the prognosis of these patients.Methods 210 patients with acute stroke were enrolled from September,2013 to February, 2014.Collection of clinical data was needed and meanwhile carried on the marks of NIHSS.The outcomes were followed up at the end of 90 day,simultaneously carried on the marks of mRS,which defined the score >2 as the poor prognosis group,≤2 as the good one.Results In enrollde 199 patients (ratio of losing was 5. 24%),47(23.62%)had a poor functional outcome.NIHSS score at admission (P =0.001),atrial fibrillation (P =0.003),alkaline phosphatase (P =0.001),uric acid (P =0.027)and high sensitivity C reactive protein (P =0.001)are factors that affect the 90 day prognosis of acute stroke patients.NIHSS score at admission(P=0.001 ,OR=1 .46,95%CI =1 .24-1 .71)and alkaline phosphatase(P =0.001 ,OR = 1 .13,95%CI = 1 .09 -1 .1 8)are independent risk factors for the prognosis of acute stroke patients.Conclusions NIHSS score at ad-mission,atrial fibrillation,alkaline phosphatase,uric acidand high sensitivity C reactive protein are factors that affect the 90 day prognosis in acute stroke patients.Serum alkaline phosphatase level in acute stage? is? an in-dependent risk factor for? the prognosis of acute stroke patients.