| 摘要: |
| ［摘要］ 目的 分析恶性肿瘤相关脑梗死患者预后不良的危险因素。方法 回顾性分析2012年1月至2022年12月广西医科大学第一附属医院收治的83例恶性肿瘤相关脑梗死患者的临床资料，根据出院时改良Rankin量表（mRS）评分将其分为预后不良组（>2分，43例）和预后良好组（≤2分，40例）。比较两组临床资料，并通过多因素logistic回归分析影响患者预后的因素，采用ROC曲线分析研究指标预测患者预后的效能。结果 多因素logistic回归分析结果显示，较高的血小板计数［OR（95%CI）=0.991（0.983～0.998），P=0.019］、血清前白蛋白水平［OR（95%CI）=0.986（0.975～0.998），P=0.022］是恶性肿瘤相关脑梗死预后良好的独立保护因素，系统炎症反应指数（SIRI）增高［OR（95%CI）=1.285（1.027～1.607），P=0.028］是预后不良的独立危险因素。ROC曲线分析结果显示，血小板计数、血清前白蛋白及SIRI均可有效预测恶性肿瘤相关脑梗死预后不良的发生（P<0.05），且三指标联合的预测效能较单一指标更优［AUC（95%CI）=0.800（0.697～0.889）］，灵敏度为74.4%，特异度为72.5%。结论 SIRI、血小板计数和血清前白蛋白水平与恶性肿瘤相关脑梗死患者预后相关，三者联合检测有助于预测患者预后。 |
| 关键词: 恶性肿瘤相关脑梗死 预后不良 影响因素 系统炎症反应指数 |
| DOI：10.3969/j.issn.1674-3806.2025.06.12 |
| 分类号:R 747.9 |
| 基金项目:国家自然科学基金项目（编号：82260243）；广西自然科学基金青年科学基金项目（编号：2022GXNSFBA035501） |
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| Analysis of risk factors for poor prognosis in patients with malignant tumor-related cerebral infarction |
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WANG Xue1, LIANG Huo1, LU Qiuhong1, HUANG Qiuhui1, CEN Gengyu1, LIANG Zhijian1,2
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1.Guangxi Medical University, Nanning 530021, China; 2.Department of Neurology, the First Affiliated Hospital of Guangxi Medical University, Nanning 530021, China
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| Abstract: |
| ［Abstract］ Objective To analyze the risk factors for poor prognosis in patients with malignant tumor-related cerebral infarction. Methods The clinical data of 83 patients with malignant tumor-related cerebral infarction who were admitted to the First Affiliated Hospital of Guangxi Medical University from January 2012 to December 2022 were retrospectively analyzed. The patients were divided into poor prognosis group(>2 points, 43 cases) and good prognosis group(≤2 points, 40 cases) according to their modified Rankin Scale(mRS) scores at discharge. The clinical data were compared between the two groups. The factors influencing the prognosis of the patients were analyzed through multivariate logistic regression, and the efficacy of the research indicators in predicting the prognosis of the patients was analyzed by using receiver operating characteristic(ROC) curve. Results The results of multivariate logistic regression analysis showed that higher platelet count［OR(95%CI)=0.991(0.983-0.998), P=0.019］ and serum prealbumin level［OR(95%CI)=0.986(0.975-0.998), P=0.022］ were independent protective factors for a good prognosis of malignant tumor-related cerebral infarction. The elevated systemic inflammation response index(SIRI)［OR(95%CI)=1.285(1.027-1.607), P=0.028］ was an independent risk factor for a poor prognosis of malignant tumor-related cerebral infarction. The results of ROC curve analysis showed that platelet count, serum prealbumin and SIRI could effectively predict the occurrence of poor prognosis of malignant tumor-related cerebral infarction(P<0.05), and the predictive efficacy of the combination of the three indicators was better than that of a single indicator［AUC(95%CI)=0.800(0.697-0.889)］, with a sensitivity of 74.4% and a specificity of 72.5%. Conclusion SIRI, platelet count and serum prealbumin levels are associated with the prognosis of the patients with malignant tumor-related cerebral infarction. The combined detection of the three indicators is helpful for predicting the prognosis of the patients. |
| Key words: Malignant tumor-related cerebral infarction Poor prognosis Influencing factors Systemic inflammation response index(SIRI) |
