前白蛋白、白蛋白對不同年齡段腦梗死短期預(yù)后的預(yù)測價值
發(fā)布時間：2018-07-20 17:53
【摘要】：目的分析急性腦梗死的危險因素,探討不同年齡段腦梗死患者血清前白蛋白及白蛋白對其短期預(yù)后的預(yù)測價值。方法病例組:納入2014年6月至2016年6月發(fā)病48小時內(nèi)入院的新發(fā)急性腦梗死患者622例,根據(jù)年齡分為小于45歲、45-59歲、60-74歲、75-89歲4組,在發(fā)病第14天行改良的Rankin量表(mRS)評分,mRS評分≤2分為預(yù)后良好,m RS評分≥3分則為預(yù)后不良。根據(jù)各年齡段預(yù)后不同,各年齡段內(nèi)又分為預(yù)后良組和預(yù)后不良組。對照組:納入同期對應(yīng)年齡及性別查體患者446例,并分為小于45歲、45-59歲、60-74歲、75-89歲4組。比較病例組與對照組、預(yù)后良與預(yù)后不良組研究對象的人口統(tǒng)計學資料(性別、年齡、體重指數(shù))、血管危險因素(高血壓、糖尿病、缺血性心臟病、房顫、吸煙、飲酒史)、血壓(收縮壓、舒張壓)、生化指標(前白蛋白、白蛋白、總白蛋白、總膽紅素、直接膽紅素、間接膽紅素、甘油三脂、總膽固醇、高密度脂蛋白膽固醇、低密度脂蛋白膽固醇、尿素氮、肌酐、尿酸、磷)差異是否有統(tǒng)計學意義。采用logistics回歸分析以上因素哪些是腦梗死的危險因素及哪些是保護性因素。分析各年齡段血清前白蛋白及白蛋白對其短期預(yù)后的預(yù)測價值。結(jié)果1、病例組與對照組相比,年齡、體重指數(shù)、高血壓、糖尿病、冠心病、房顫、吸煙及飲酒史比例及收縮壓和舒張壓高低,以及前白蛋白、白蛋白、總白蛋白、總膽固醇、甘油三酯、高密度脂蛋白膽固醇、總膽紅素、間接膽紅素、肌酐、尿酸水平差別均具有統(tǒng)計學意義(P0.05),進行多變量logistic回歸分析,年齡、體重指數(shù)、吸煙、房顫、血壓(收縮壓、舒張壓)、總膽固醇、直接膽紅素、肌酐為腦梗死的獨立危險因素,而前白蛋白、白蛋白、總蛋白、高密度脂蛋白膽固醇、總膽紅素、尿酸為獨立保護性因素。2、對于病例組,預(yù)后良與預(yù)后不良組相比,兩組研究對象年齡、體重指數(shù)及性別差異、糖尿病、房顫病人的比例,以及前白蛋白、白蛋白、甘油三脂、高密度脂蛋白膽固醇、低密度脂蛋白膽固醇、總膽紅素、直接膽紅素、間接膽紅素、尿素氮、肌酐、尿酸差別均具有統(tǒng)計學意義(P0.05),多變量logistic回歸分析示,性別、糖尿病、低密度脂蛋白膽固醇、總膽紅素、尿素氮為腦梗死預(yù)后不良的獨立危險因素,而體重指數(shù)、前白蛋白、白蛋白、甘油三酯、肌酐為獨立保護性因素。3、對病例組與對照組、預(yù)后良與預(yù)后不良組進行多變量logistic回歸分析,在校正其他腦梗死的危險因素后,前白蛋白及白蛋白為腦梗死及其短期預(yù)后的獨立保護性因素(病例對照組:前白蛋白OR=0.981,P0.001,白蛋白OR=0.819,P0.001;預(yù)后良與預(yù)后不良組:前白蛋白OR=0.997,P0.034,白蛋白OR=0.941,P0.020)。4、對于病例組預(yù)后良與預(yù)后不良組的預(yù)測分析中,僅小于45歲組前白蛋白對腦梗死的短期預(yù)后有預(yù)測價值(ROC曲線下面積為0.768,95%CI為0.617-0.919,P=0.022),其他各組均無明顯的預(yù)測價值。結(jié)論前白蛋白及白蛋白是急性腦梗死及其短期預(yù)后的獨立保護性因素,不同年齡段急性腦梗死前白蛋白及白蛋白對其短期預(yù)后的價值不同,前白蛋白對小于45歲的腦梗死患者的短期預(yù)后有預(yù)測價值。
[Abstract]:Objective to analyze the risk factors of acute cerebral infarction and to explore the predictive value of serum prealbumin and albumin on the short-term prognosis of cerebral infarction in different age groups. Method case group: 622 cases of newly onset acute cerebral infarction hospitalized within 48 hours from June 2014 to June 2016 were divided into 45 years old, 45-59 years old, 60-74 years old, 7 The improved Rankin scale (mRS) score of the 5-89 year old group was scored on fourteenth days, the mRS score was less than 2 and the prognosis was good, and the m RS score was worse than 3. According to the different age groups, the prognosis group was divided into good prognosis group and poor prognosis group. The control group was included in 446 cases of age and sex examination in the same period, and divided into less than 45. Age, 45-59 years, 60-74 years, 75-89 years old and 4 groups. Compare the demographic data (sex, age, body mass index), blood vessel risk factors (hypertension, diabetes, ischemic heart disease, atrial fibrillation, smoking, drinking history), blood pressure (systolic pressure, diastolic pressure), biochemical index (prealbumin, white egg). White, total bilirubin, total bilirubin, direct bilirubin, indirect bilirubin, glycerin three fat, total cholesterol, high density lipoprotein cholesterol, low density lipoprotein cholesterol, urea nitrogen, creatinine, uric acid, phosphorus, were statistically significant. Logistics regression analysis of the above factors are the risk factors of cerebral infarction and which are protective causes Analysis of the prognostic value of serum prealbumin and albumin in all ages. Results 1. Age, body mass index, hypertension, diabetes, coronary heart disease, atrial fibrillation, smoking and drinking history, systolic pressure and diastolic pressure, and prealbumin, albumin, total albumin, total albumin, total cholesterol, glycerol three, compared with the control group. Esters, high density lipoprotein cholesterol, total bilirubin, indirect bilirubin, creatinine, and uric acid levels were all statistically significant (P0.05). Multivariable logistic regression analysis, age, body mass index, smoking, atrial fibrillation, blood pressure (systolic pressure, diastolic pressure), total cholesterol, direct bilirubin, creatinine as independent risk factors for cerebral infarction, and pre white eggs White, albumin, total protein, high density lipoprotein cholesterol, total bilirubin, uric acid as an independent protective factor.2. Compared with the group with good prognosis and poor prognosis, the two groups of subjects were age, body mass index and sex difference, the proportion of diabetes, atrial fibrillation, and prealbumin, albumin, glycerol three fat, high density lipoprotein gallbladder Alcohol, low density lipoprotein cholesterol, total bilirubin, direct bilirubin, indirect bilirubin, urea nitrogen, creatinine and uric acid were all statistically significant (P0.05). Multivariate logistic regression analysis showed that sex, diabetes, low density lipoprotein cholesterol, total cholesterol, urea nitrogen were independent risk factors for poor prognosis of cerebral infarction, and body mass index Prealbumin, albumin, triglyceride, creatinine were independent protective factors of.3. A multivariate logistic regression analysis was performed in a case group and a control group with good prognosis and poor prognosis. After correcting the risk factors of other cerebral infarction, prealbumin and albumin were independent protective factors for cerebral infarction and its short-term prognosis. Albumin OR=0.981, P0.001, albumin OR=0.819, P0.001; prognosis good and poor prognosis group: prealbumin OR=0.997, P0.034, albumin OR=0.941, P0.020).4. In the prediction analysis of benign and poor prognosis group of case group prognosis, only 45 years old group prealbumin is of predictive value for the short-term prognosis of cerebral infarction (ROC curve area is 0.768,95%CI. 0.617-0.919, P=0.022), other groups have no significant predictive value. Conclusion prealbumin and albumin are independent protective factors for acute cerebral infarction and its short-term prognosis. The value of prealbumin and albumin for the short-term prognosis of acute cerebral infarction in different ages is different, prealbumin is prealbumin for short term prealbumin for patients less than 45 years of age. Then there is a predictive value.
【學位授予單位】：青島大學
【學位級別】：碩士
【學位授予年份】：2017
【分類號】：R743.33
[Abstract]:Objective to analyze the risk factors of acute cerebral infarction and to explore the predictive value of serum prealbumin and albumin on the short-term prognosis of cerebral infarction in different age groups. Method case group: 622 cases of newly onset acute cerebral infarction hospitalized within 48 hours from June 2014 to June 2016 were divided into 45 years old, 45-59 years old, 60-74 years old, 7 The improved Rankin scale (mRS) score of the 5-89 year old group was scored on fourteenth days, the mRS score was less than 2 and the prognosis was good, and the m RS score was worse than 3. According to the different age groups, the prognosis group was divided into good prognosis group and poor prognosis group. The control group was included in 446 cases of age and sex examination in the same period, and divided into less than 45. Age, 45-59 years, 60-74 years, 75-89 years old and 4 groups. Compare the demographic data (sex, age, body mass index), blood vessel risk factors (hypertension, diabetes, ischemic heart disease, atrial fibrillation, smoking, drinking history), blood pressure (systolic pressure, diastolic pressure), biochemical index (prealbumin, white egg). White, total bilirubin, total bilirubin, direct bilirubin, indirect bilirubin, glycerin three fat, total cholesterol, high density lipoprotein cholesterol, low density lipoprotein cholesterol, urea nitrogen, creatinine, uric acid, phosphorus, were statistically significant. Logistics regression analysis of the above factors are the risk factors of cerebral infarction and which are protective causes Analysis of the prognostic value of serum prealbumin and albumin in all ages. Results 1. Age, body mass index, hypertension, diabetes, coronary heart disease, atrial fibrillation, smoking and drinking history, systolic pressure and diastolic pressure, and prealbumin, albumin, total albumin, total albumin, total cholesterol, glycerol three, compared with the control group. Esters, high density lipoprotein cholesterol, total bilirubin, indirect bilirubin, creatinine, and uric acid levels were all statistically significant (P0.05). Multivariable logistic regression analysis, age, body mass index, smoking, atrial fibrillation, blood pressure (systolic pressure, diastolic pressure), total cholesterol, direct bilirubin, creatinine as independent risk factors for cerebral infarction, and pre white eggs White, albumin, total protein, high density lipoprotein cholesterol, total bilirubin, uric acid as an independent protective factor.2. Compared with the group with good prognosis and poor prognosis, the two groups of subjects were age, body mass index and sex difference, the proportion of diabetes, atrial fibrillation, and prealbumin, albumin, glycerol three fat, high density lipoprotein gallbladder Alcohol, low density lipoprotein cholesterol, total bilirubin, direct bilirubin, indirect bilirubin, urea nitrogen, creatinine and uric acid were all statistically significant (P0.05). Multivariate logistic regression analysis showed that sex, diabetes, low density lipoprotein cholesterol, total cholesterol, urea nitrogen were independent risk factors for poor prognosis of cerebral infarction, and body mass index Prealbumin, albumin, triglyceride, creatinine were independent protective factors of.3. A multivariate logistic regression analysis was performed in a case group and a control group with good prognosis and poor prognosis. After correcting the risk factors of other cerebral infarction, prealbumin and albumin were independent protective factors for cerebral infarction and its short-term prognosis. Albumin OR=0.981, P0.001, albumin OR=0.819, P0.001; prognosis good and poor prognosis group: prealbumin OR=0.997, P0.034, albumin OR=0.941, P0.020).4. In the prediction analysis of benign and poor prognosis group of case group prognosis, only 45 years old group prealbumin is of predictive value for the short-term prognosis of cerebral infarction (ROC curve area is 0.768,95%CI. 0.617-0.919, P=0.022), other groups have no significant predictive value. Conclusion prealbumin and albumin are independent protective factors for acute cerebral infarction and its short-term prognosis. The value of prealbumin and albumin for the short-term prognosis of acute cerebral infarction in different ages is different, prealbumin is prealbumin for short term prealbumin for patients less than 45 years of age. Then there is a predictive value.
【學位授予單位】：青島大學
【學位級別】：碩士
【學位授予年份】：2017
【分類號】：R743.33
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