血浆和肽素水平与急性脑梗死患者病情及近期预后的关系分析

摘要

目的 探讨血浆和肽素水平与急性脑梗死患者病情及近期预后情况的关系.方法 采用前赡性研究方法,选取2016年9月至2017年9月苏州市中西医结合医院收治的50例急性脑梗死患者(观察组),以及同期来苏州市中西医结合医院体检中心体检的50例健康者(对照组)作为研究对象,对比观察组患者入院时与对照组患者体检时的血浆和肽素水平、不同病情的观察组患者入院1 d、1 周及半个月的血浆和肽素水平比较、预后良好和预后不良的观察组患者的血浆和肽素水平和卒中量表平均评分比较情况;根据病情严重程度分为轻症组(22例)和重症组(28例),对比两组患者在入院1 d、1 周及半个月的血浆和肽素水平;对比预后良好和预后不良的观察组患者的血浆和肽素水平.结果 观察组患者入院时的血浆和肽素水平(7.64 ± 1.40 pmol /L)明显高于对照组患者体检时(1.79 ± 0.42 pmol /L);观察组患者中轻症患者入院1 d(5.75 ± 0.81 pmol /L)、1 周(3.08 ± 0.63 pmol /L)及半个月的血浆和肽素水平(1.78 ± 0.37 pmol /L)明显低于观察组中重症患者入院1 d(9.13 ± 1.32 pmol /L)、1 周(8.82 ± 1.65 pmol /L)及半个月的血浆和肽素水平(4.02 ± 0.66 pmol /L);观察组中预后良好的患者的血浆和肽素水平(1.32 ± 0.47 pmol /L)显著低于观察组中预后不良患者血浆和肽素水平(3.05 ± 0.78 pmol /L);卒中量表平均评分(5 ± 0.47 分)低于观察组中预后不良的患者卒中量表平均评分(10 ± 0.47 分),差异均具有统计学意义(P ＜ 0.05).结论 急性脑梗死患者的病情和近期预后情况与和血浆肽素水平相关,如果发现急性脑梗死患者的血浆和血浆肽素水平明显升高,应及早处理,采取积极的干预手段,可以改善病情,减少不良结果 的发生.%Objective To investigate the relationship among plasma copeptin levels,condition and short - term prognosis of patients with acute cerebral infarction. Methods 50 patients with acute cerebral infarction (observation group) admitted from September 2016 to September 2017 and 50 healthy persons (control group) for physical examination in our center during the same period were prospectively selected as research objects. The plasma copeptin levels and average stroke scale score were compared between observation group and control group and between subgroups (mild group,n = 22 and severe group,n = 28) at different time horizons. Results The plasma copeptin levels in observation group at admission (7. 64 ± 1. 40 pmol /L) were significantly higher than control group at physical examination (1. 79 ± 0. 42 pmol /L); the plasma copeptin levels in mild patients at admission after 1 day (5. 75 ± 0. 81),1 week (3. 08 ± 0. 63) and half a month (1. 78 ± 0. 37) were significantly lower than severe patients accordingly,namely 1 day (9. 13 ± 1. 32),1 week (8. 82 ± 1. 65) and half a month (4. 02 ± 0. 66). The plasma copeptin levels of those with good prognosis in observation group (1. 32 ± 0. 47) were significantly lower than those with poor prognosis in observation group (3. 05 ± 0. 78). The average stroke scale score of those with good prognosis in observation group (5 ± 0. 47) was lower than those with poor prognosis in observation group (10 ± 0. 47) (P ＜ 0. 05). Conclusion The condition and short - term prognosis of patients with acute cerebral infarction are related to plasma copeptin level. On discovery of increased plasma copeptin,early and active intervention measures should be taken to improve condition and reduce adverse outcomes in cerebral infarction patients.