文章摘要
高敏肌钙蛋白T与急性前循环大血管闭塞性卒中血管内治疗患者预后的相关性分析
Correlation between high sensitivity troponin T level and prognosis in patients with acute anterior circulation macrovascular occlusive strokeKONG Yu-Ming,WANG Jia-Hui,LIZhi-Zhang,ZHANG Xiao-Guang,ZHANGDong,MA Rui-Nan,YUE Yun-Hua. Departmentof Neurology,Yangpu Hospital Tongji UniversitySchool of Medicine. Shanghai 200090,China
投稿时间:2022-05-31  修订日期:2022-05-31
DOI:
中文关键词: 脑卒中  前循环大血管闭塞  高敏肌钙蛋白T  不良预后  危险因素
英文关键词: Acute ischemic stroke  Anterior circulation large vessel occlusion  High-sensitivity troponin t  Poorprognosis  Risk factor
基金项目:上海市科学技术委员会科研计划项目(18411970100)
作者单位E-mail
孔玉明 同济大学附属杨浦医院(上海市杨浦区中心医院) kym20021983@163.com 
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中文摘要:
      目的:探讨早期高敏肌钙蛋白T(high-sensitivity troponin T,hs-cTnT)水平与急性前循环大血管闭塞性卒中(anterior circulation large vessel occlusion stroke,ALVOS)血管内治疗患者预后的关系。方法:回顾性分析 2018 年1月至2020年6月期间在同济大学附属杨浦医院神经内科行血管内治疗的急性前循环大血管闭塞性卒中患者的临床资料。根据评定的入选患者3个月后mRS评分,分为良好预后组(mRS<3分)和不良预后组(mRS≥3分),比较两组基线资料。通过单因素分析及多因素logistic回归分析得出预后的独立危险因素,使用ROC曲线下面积评估hs-cTnT对预后不良的预测价值。结果:最终纳入127例患者,其中预后良好55例(43.3%),预后不良72例(56.7%)。多因素logistic回归表明hs-cTnT升高(OR1.037, 95%CI 1.000-1.075,P=0.047),年龄增加(OR 1.070, 95%CI 1.020-1.123,P=0.005),取栓次数增加(OR 1.912, 95%CI 1.149-3.182,P=0.017),ASPECT评分降低(OR 1.479, 95%CI1.005-2.174,P=0.041)以及颈内动脉闭塞(OR 4.695, 95%CI1.524-14.492,P=0.007)是预后不良的独立危险因素。hs-cTnT预测预后不良的ROC曲线下面积为0.730(95%CI0.643-0.816,P<0.001),最佳截断值为15.45ng/l,敏感度63.9%,特异度69.1%。结论:早期hs-cTnT升高是ALVOS血管内治疗患者3个月预后不良的独立危险因素,对预后的预测有一定价值。
英文摘要:
      Objective To investigate the correlation between the early high-sensitivity troponin T (hs-cTnT)level and the prognosis of endovascular treatment for anterior circulation large vessel occlusion stroke(ALVOS). Methods Data of consecutive patients with anterior circulation large vessel occlusion who received emergency endovascular treatment in Yangpu Hospital,Tongji University from January 2018 to June 2020 were retrospectively analyzed. According to the mRS score after 3 months of evaluation, the patients were divided into two groups: good prognosis group (mRS<3 points) and poor prognosis group (mRS≥ 3 points). The baseline data of the two groups were compared,. The independent risk factors of prognosis were obtained by univariate analysis and multivariate logistic regression analysis. The area under ROC curve was used to evaluate the predictive value of hs-cTnT for poor prognosis. Results A total of 127 eligible patients were included.55 cases (43.3%) had good prognosis and 72 cases (56.7%) had poor prognosis. Multivariate logistic regression showed that hs-cTnT increased (OR 1.037, 95%CI 1.000-1.075, P = 0.047), age increased (OR 1.070, 95%CI 1.020-1.123, P = 0.005), the number of thrombus extraction increased (OR 1.912, 95%CI 1.149-3.182, P = 0.017), ASPECT score decreased (OR 1.479, 95%CI 1.005-2.174). P = 0.041) and internal carotid artery occlusion (OR 4.695, 95%CI 1.524-14.492, P = 0.007) were independent risk factors for poor prognosis. The area under ROC curve predicted by hs-cTnT was 0.730 (95%CI 0.643-0.816, P 0.001), the best cut-off value was 15.45ng /l, the sensitivity was 63.9%, and the specificity was 69.1%. Conclusions The increase of hs-cTnT in the early stage is an independent risk factor for the poor prognosis of patients with ALVOS endovascular therapy for 3 months.
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