|
肖琼怡.视神经鞘直径对大面积脑梗死患者近期预后有预测价值[J].内科急危重症杂志,2026,32(1):61-65
|
| DOI：10.11768/nkjwzzzz20260114 |
| 中文关键词: 急性缺血性脑卒中 视神经鞘直径 神经功能 预后 预测 |
| 英文关键词: |
| 基金项目: |
|
| 摘要点击次数: 56 |
| 全文下载次数: 60 |
| 中文摘要: |
| 摘要 目的：分析大面积脑梗死（LHI）患者视神经鞘直径（ONSD）与近期预后的相关性及预测价值。方法：选取LHI患者175例，治疗后3个月应用改良Rankin量表评估预后，根据预后情况分为预后不良组49例和预后良好组126例，比较2组治疗前临床资料、ONSD，应用Logistic回归分析ONSD与LHI患者预后的关联性，应用受试者工作特征（ROC）曲线分析ONSD预测LHI患者预后不良的价值，将预后不良的常规影响因素作为基础预测方案，在基础预测方案上联合ONSD作为新预测方案，比较2种方案的预测效能。结果：LHI患者治疗后3个月预后不良率为28.00%；预后不良组年龄、糖尿病、发病至治疗时间、治疗前大脑中动脉狭窄率、颈动脉狭窄率、美国国立卫生研究院卒中量表（NIHSS）评分、白细胞计数、ONSD高于预后良好组（P均＜0.05）；发病至治疗时间、治疗前ONSD及年龄、大脑中动脉狭窄率、颈动脉狭窄率、NIHSS评分均与LHI患者预后存在显著关联性（P均＜0.05）；治疗前ONSD预测LHI患者预后不良的曲线下面积（AUC）为0.743（95%CI：0.671～0.806）；基础方案预测LHI患者预后不良的AUC为0.854（95%CI：0.793～0.903），新方案的AUC为0.939（95%CI：0.893～0.970），新方案优于基础方案（P＜0.05）。结论：治疗前高ONSD是LHI患者预后不良的独立危险因素，对预后不良具有一定预测效能。 |
| 英文摘要: |
| Abstract Objective: To analyze the correlation between optic nerve sheath diameter (ONSD) and short-term prognosis in patients with large hemispheric infarction (LHI) and its predictive value. Methods: A total of 175 patients with LHI were enrolled in this study. The modified Rankin scale was used to evaluate the prognosis at 3rd month after treatment. According to the prognosis, the patients were divided into poor prognosis group (49 cases) and good prognosis group (126 cases). The clinical data and ONSD before treatment were compared between the two groups. Logistic regression was used to analyze the correlation between ONSD and the prognosis of patients with LHI. The receiver operating characteristic (ROC) curve was used to analyze the value of ONSD in predicting the poor prognosis of patients with LHI. The conventional influencing factors of poor prognosis were used as the basic prediction scheme. On the basis of the basic prediction scheme, ONSD was combined as a new prediction scheme, and the prediction efficiency of the two schemes was compared. Results: The poor prognosis rate of LHI patients at 3rd month after treatment was 28.00%. The age, diabetes, time from onset to treatment, middle cerebral artery stenosis rate before treatment, carotid artery stenosis rate, National Institutes of Health Stroke Scale (NIHSS) score, white blood cell count and ONSD in the poor prognosis group were significantly higher than those in the good prognosis group (all P<0.05). The time from onset to treatment, ONSD before treatment, age, middle cerebral artery stenosis rate, carotid artery stenosis rate and NIHSS score were significantly correlated with the prognosis of LHI patients (all P<0.05). The area under the curve (AUC) of ONSD in predicting poor prognosis of LHI patients before treatment was 0.743 (95%CI: 0.671~0.806). The AUC of the basic scheme for predicting poor prognosis in LHI patients was 0.854 (95%CI: 0.793~0.903), and the AUC of the new scheme was 0.939 (95%CI: 0.893~0.970), the new scheme was superior to the basic scheme (P<0.05). Conclusion: High ONSD before treatment is an independent risk factor for poor prognosis in patients with LHI, and has a certain predictive effect on poor prognosis. |
|
|
|
|
