临床神经病学杂志
臨床神經病學雜誌
림상신경병학잡지
JOURNAL OF CLINICAL NEUROLOGY
2015年
2期
107-109
,共3页
王娜%毕国荣%刘然%张旭东
王娜%畢國榮%劉然%張旭東
왕나%필국영%류연%장욱동
血清铁蛋白%出血转化%急性缺血性脑卒中
血清鐵蛋白%齣血轉化%急性缺血性腦卒中
혈청철단백%출혈전화%급성결혈성뇌졸중
serum ferritin%hemorrhagic transformation%acute cerebral ischemic stroke
目的:探讨血清铁蛋白水平对急性缺血性脑卒中患者发生出血转化( HT)的预测价值。方法189例急性缺血性脑卒中患者根据CT复查结果分为HT组和非HT( non-HT)组,同时将HT组分为出血性梗死( HI)亚组和脑实质血肿( PH)亚组。采用ELISA法检测患者发病48 h内血清铁蛋白水平,比较各组血清铁蛋白水平,评估其对HT的预测意义。结果 CT结果显示,189例急性缺血性脑卒中患者中发生HT者87例(46%),其中HI 66例、PH 21例。 HT组血清铁蛋白水平[(175.49±109.09) ng/mL]明显高于non-HT组[(117.25±78.42) ng/mL](P<0.01)。 PH亚组血清铁蛋白水平[(245.18±103.63) ng/mL]明显高于HI亚组[(153.31±101.84) ng/mL](P<0.01)。多因素Logistic回归分析显示,血清铁蛋白水平升高是急性缺血性脑卒中患者发生HT的独立危险因素(OR=1.004,95%CI:1.000~1.008, P=0.029),同时也是发生PH的独立危险因素( OR=1.006,95%CI:1.001~1.011, P=0.021)。血清铁蛋白水平预测急性缺血性脑卒中患者发生HT和PH的ROC曲线下面积分别为0.687(95%CI:0.611~0.763, P<0.001)、0.782(95%CI:0.652~0.913, P<0.001),预测值分别为131.5 ng/ml、182.0 ng/ml。结论血清铁蛋白水平升高是急性缺血性脑卒中患者发生HT、PH的独立危险因素。血清铁蛋白水平对急性缺血性脑卒中患者发生HT具有预测价值。
目的:探討血清鐵蛋白水平對急性缺血性腦卒中患者髮生齣血轉化( HT)的預測價值。方法189例急性缺血性腦卒中患者根據CT複查結果分為HT組和非HT( non-HT)組,同時將HT組分為齣血性梗死( HI)亞組和腦實質血腫( PH)亞組。採用ELISA法檢測患者髮病48 h內血清鐵蛋白水平,比較各組血清鐵蛋白水平,評估其對HT的預測意義。結果 CT結果顯示,189例急性缺血性腦卒中患者中髮生HT者87例(46%),其中HI 66例、PH 21例。 HT組血清鐵蛋白水平[(175.49±109.09) ng/mL]明顯高于non-HT組[(117.25±78.42) ng/mL](P<0.01)。 PH亞組血清鐵蛋白水平[(245.18±103.63) ng/mL]明顯高于HI亞組[(153.31±101.84) ng/mL](P<0.01)。多因素Logistic迴歸分析顯示,血清鐵蛋白水平升高是急性缺血性腦卒中患者髮生HT的獨立危險因素(OR=1.004,95%CI:1.000~1.008, P=0.029),同時也是髮生PH的獨立危險因素( OR=1.006,95%CI:1.001~1.011, P=0.021)。血清鐵蛋白水平預測急性缺血性腦卒中患者髮生HT和PH的ROC麯線下麵積分彆為0.687(95%CI:0.611~0.763, P<0.001)、0.782(95%CI:0.652~0.913, P<0.001),預測值分彆為131.5 ng/ml、182.0 ng/ml。結論血清鐵蛋白水平升高是急性缺血性腦卒中患者髮生HT、PH的獨立危險因素。血清鐵蛋白水平對急性缺血性腦卒中患者髮生HT具有預測價值。
목적:탐토혈청철단백수평대급성결혈성뇌졸중환자발생출혈전화( HT)적예측개치。방법189례급성결혈성뇌졸중환자근거CT복사결과분위HT조화비HT( non-HT)조,동시장HT조분위출혈성경사( HI)아조화뇌실질혈종( PH)아조。채용ELISA법검측환자발병48 h내혈청철단백수평,비교각조혈청철단백수평,평고기대HT적예측의의。결과 CT결과현시,189례급성결혈성뇌졸중환자중발생HT자87례(46%),기중HI 66례、PH 21례。 HT조혈청철단백수평[(175.49±109.09) ng/mL]명현고우non-HT조[(117.25±78.42) ng/mL](P<0.01)。 PH아조혈청철단백수평[(245.18±103.63) ng/mL]명현고우HI아조[(153.31±101.84) ng/mL](P<0.01)。다인소Logistic회귀분석현시,혈청철단백수평승고시급성결혈성뇌졸중환자발생HT적독립위험인소(OR=1.004,95%CI:1.000~1.008, P=0.029),동시야시발생PH적독립위험인소( OR=1.006,95%CI:1.001~1.011, P=0.021)。혈청철단백수평예측급성결혈성뇌졸중환자발생HT화PH적ROC곡선하면적분별위0.687(95%CI:0.611~0.763, P<0.001)、0.782(95%CI:0.652~0.913, P<0.001),예측치분별위131.5 ng/ml、182.0 ng/ml。결론혈청철단백수평승고시급성결혈성뇌졸중환자발생HT、PH적독립위험인소。혈청철단백수평대급성결혈성뇌졸중환자발생HT구유예측개치。
Objective To investigate the predictive value of serum ferritin level on hemorrhagic transformation ( HT) in patients with acute cerebral ischemic stroke.Methods According to the CT results, the 189 patients with acute cerebral ischemic stroke were divided into HT group and non-HT group.And the HT group was divided into hemorrhagic infarction ( HI) subgroup and parenchymal hematoma ( PH) subgroup.The level of serum ferritin during 48 h after onset was determined by the ELISA method.The predictive value for HT was assessed.Results CT detection showed that HT in the 189 patients with acute cerebral ischemic stroke were 87 cases (46%), according to HI 66 cases and PH 21 cases.The serum ferritin level in HT group [(175.49 ±109.09) ng/mL] was significantly higher than that in non-HT group [(117.25 ±78.42) ng/mL] (P<0.01).The serum ferritin level in PH subgroup [(245.18 ±103.63) ng/mL] was significantly higher than that in HI subgroup [(153.31 ±101.84) ng/mL](P<0.01).Multivariate logistic analysis showed that high level of serum ferritin was the independent risk factor for HT (OR=1.004, 95%CI:1.000-1.008, P=0.029), and also for PH (OR=1.006, 95%CI:1.001-1.011, P=0.021) .The area under the ROC curve of serum ferritin level to predict the HT and PH was 0.687 ( 95%CI:0.611-0.763, P<0.001) and 0.782 (95%CI:0.652-0.913, P<0.001), respectively.And the predictive value was 131.5 ng/ml and 182.0 ng/ml, respectively.Conclusions High level of serum ferritin is the independent risk factor for HT, PH in patients with acute cerebral ischemic stroke.The serum ferritin level has a predictive value on HT in patients with acute cerebral ischemic stroke.