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| Hcy D-D及凝血四项水平与脑梗死患者预后的关系 |
| Association of homocysteine, d-dimer, and coagulation profiles with prognosis in cerebral infarction |
| 投稿时间：2025-04-10 |
| DOI：10.3969/j.issn.1000-0399.2026.02.011 |
| 中文关键词: D-二聚体 同型半胱氨酸 凝血四项 脑梗死 预后 |
| 英文关键词: D-dimer Homocysteine Coagulation four items Cerebral infarction Prognosis |
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| 摘要点击次数: 336 |
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| 中文摘要: |
| 目的 探讨同型半胱氨酸（Hcy）、D-二聚体（D-D）、凝血四项与脑梗死患者预后的关系。方法 回顾性分析2022年1月至2023年12月芜湖市第二人民医院收治的100例脑梗死患者临床资料，治疗后90 d天运用改良Rankin量表（mRS）评估预后，分预后不良组（n=50,mRS评分>2分）和预后良好组（n=50,mRS评分≤2分）。比较两组患者一般资料及血清D-D、Hcy、凝血四项[纤维蛋白原（FIB）、凝血酶原时间（PT）、凝血酶时间（TT）、活化部分凝血活酶时间（APTT）]水平差异。通过多因素logistic回归分析脑梗死患者预后不良的危险因素，采用受试者工作特征（ROC）曲线分析相关指标的预测价值。结果 预后不良组入院时NIHSS评分、血清D-D、Hcy、FIB水平高于预后良好组（P<0.05）,PT、TT水平低于预后良好组（P<0.05）；入院时患者NIHSS评分高、血清D-D、Hcy、PT、TT、FIB水平高为脑梗死预后不良的危险因素。经ROC曲线分析得到，入院时NIHSS评分、血清D-D、Hcy、PT、TT、FIB水平均可预测患者脑梗死预后不良，曲线下面积分别为0.767、0.819、0.635、0.794、0.869、0.786,P<0.05。以上指标联合预测的AUC为0.924(95%CI:0.876～0.971)，灵敏度为0.880，特异度为0.920。结论 脑梗死患者预后不良受入院时NIHSS评分、血清D-D、Hcy、PT、TT、FIB水平影响，临床医师需密切监测上述指标。 |
| 英文摘要: |
| Objective To explore the relationship between homocysteine(Hcy), D-dimer(D-D), coagulation and the prognosis of cerebral infarction. Methods A total of 100 patients with cerebral infarction admitted to Wuhu Second People's Hospital from January 2022 to December 2023 were retrospectively included. After 90 days of treatment, the modified Rankin Scale(mRS) was used to evaluate the prognosis, with a poor prognosis group(n=50, mRS score>2 points) and a good prognosis group(n=50, mRS score ≤2 points). The general information and serum levels of D-D, Hcy, and coagulation [Fibrinogen(FIB), prothrombin time(PT), thrombin time(TT), activated partial thromboplastin time(APTT)] were compared between two groups of patients. The predictive value of risk factors and related indicators was predicted through multivariate logistic analysis and ROC analysis. Results The NIHSS score, serum D-D, Hcy and FIB of the poor prognosis group at admission were significantly higher than those of the good prognosis group(P< 0.05), while PT and TT were significantly lower than those of the good prognosis group(P< 0.05). Multivariate analysis confirmed that admission NIHSS score, serum D-D, Hcy, PT, TT, and FIB were independent risk factors for poor prognosis(P< 0.05). Receiver operating characteristic(ROC) curve analysis demonstrated that admission NIHSS score, serum D-D, Hcy, PT, TT, and FIB levels could effectively predict poor prognosis, with area under the curve(AUC) value of 0.767, 0.819, 0.635, 0.794, 0.869, and 0.786, respectively(P< 0.05).The AUC of the combined prediction of the above indicators was 0.924(95% CI: 0.876～0.971), with a sensitivity of 0.880 and a specificity of 0.920, which was higher than that of each. Conclusion The poor prognosis of patients with cerebral infarction is influenced by the NIHSS score at admission, serum D-D, Hcy, PT, TT, and FIB levels. Clinicians should closely monitor these indicators during the treatment of this disease. |
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