炎性反应相关指标与院内症状性卒中患者不良预后相关

doi:10.16352/j.issn.1001-6325.2025.08.1083

基础医学与临床 ›› 2025, Vol. 45 ›› Issue (8): 1083-1087.doi: 10.16352/j.issn.1001-6325.2025.08.1083

炎性反应相关指标与院内症状性卒中患者不良预后相关

李楠^1#, 张贵涛^2#, 王彬³, 冯瑶², 李淑娟², 周瑛华^2*

1.武安市第一人民医院神经内科,邯郸 056300;
2.中国医学科学院北京协和医学院国家心血管病中心心血管疾病国家重点实验室阜外医院神经内科,北京 100037;
3.临清市人民医院神经内科, 山东聊城 252699

收稿日期:2024-07-25 修回日期:2024-11-22 出版日期:2025-08-05 发布日期:2025-07-11
通讯作者: ^*yhzhou2008@sina.com
作者简介:^#对本文有相同贡献
基金资助:
中央高水平医院临床研究基金(2022-GSP-TS-4,2023-GSP-GG-37,2023-GSP-QN-12);中国医学科学院临床与转化研究基金(2022-I2M-C&T-B-046)

Correlation between inflammatory response-related indicators and poor outcomes of in-hospital patients with symptomatic stroke

LI Nan^1#, ZHANG Guitao^2#, WANG Bin³, FENG Yao², LI Shujuan², ZHOU Yinghua^2*

1. Department of Neurology, Wu'an First People's Hospital, Handan 056300;
2. Department of Neurology, Fuwai Hospital, State Key Laboratory of Cardiovascular Disease, National Center of Cardiovascular Disease, CAMS & PUMC, Beijing 100037;
3. Department of Neurology, Linqing People's Hospital, Liaocheng 252699, Chin.

Received:2024-07-25 Revised:2024-11-22 Online:2025-08-05 Published:2025-07-11
Contact: ^*yhzhou2008@sina.com

摘要/Abstract

摘要： 目的分析炎性反应指标(全身炎性反应指数及系统性免疫炎性指数)与院内症状性卒中患者不良预后的相关性。方法本研究为前瞻性队列研究,连续性纳入2023年1月至9月在中国医学科学院阜外医院住院期间发生症状性卒中患者,收集患者的既往病史、临床症状及体征,采用美国国立卫生院卒中量表(NIHSS)评估神经系统损伤的严重程度。记录实验室化验结果,并计算全身炎性反应指数(SIRI)、系统性免疫炎性指数(SII)。在卒中发生后90 d对患者进行随访,采用改良Rankin量表评估患者神经功能预后,0~1分为预后良好,≥2分为预后不良。以多因素Logistic回归评估炎症反应指标和预后不良的相关性。结果共纳入院内症状性卒中患者 97 例,年龄(61.8±12.7)岁,其中女性28例(28.9%,28/97),合并既往卒中9例(9.3%,9/97),心房颤动(房颤)15例(15.5%,15/97),心力衰竭16例(16.5%,16/97),心肌梗死7例(7.2%,7/97)。相关性分析显示,卒中发病时NIHSS评分与患者卒中后SIRI(r=0.237,P＜0.05)及SII(r=0.234,P＜0.05)呈显著正相关。院内卒中发生后90 d随访,预后不良41例(42.3%,41/97)。多因素Logistic回归分析显示卒中后SIRI(OR=4.71,95% CI:1.24~17.90)和SII(OR=3.13,95% CI:0.88~11.06)与卒中后90 d的预后不良存在相关性。采用限制性立方样条图分析显示,随着SIRI、SII水平增高,院内症状性卒中患者90 d预后不良风险呈增加趋势。结论 SIRI是院内症状性卒中患者不良预后的独立危险因素,且随着SIRI水平增高,卒中预后不良的风险增加。

关键词: 院内卒中, 全身炎性反应指数, 系统性免疫炎性指数, 美国国立卫生院卒中量表, 预后不良

Abstract: Objective To analyze the correlation between inflammation indicators(systemic inflammatory response syndrome and systemic immune-inflammation index) and adverse outcomes in patients with symptomatic stroke during hospitalization. Methods This study was a prospective cohort study including consecutive patients with symptomatic stroke who were hospitalized in Fuwai Hospital from January to September 2023. The past medical history, clinical symptoms and signs of the patients were collected. The neurological damage was evaluated with National Institute of Health Stroke Scale(NIHSS). Laboratory test results were recorded and the SIRI and SII index were calculated. Patients were followed up for 90 days after the stroke, and their neurological outcomes were evaluated using the modified Rankin Scale. A score of 0-1 was classified as good outcome, and a score ≥2 was classified as poor outcome. The correlation between inflammatory response indicators and poor outcomes was assessed using multiple Logistic regression. Results A total of 97 patients with in-hospital symptomatic stroke were included with an average age of 61.8±12.7 years. Among them, there were 28 females(28.9%, 28/97), 9 with a history of prior stroke(9.3%, 9/97), 15 with atrial fibrillation(15.5%, 15/97), 16 with heart failure(16.5%, 16/97), and 7 with myocardial infarction(7.2%, 7/97). Correlation analysis showed that the NIHSS score at the time of stroke onset was significantly correlated with the patient's post-stroke SIRI(r=0.237, P＜0.05) and SII(r=0.234, P＜0.05). After 90 days of follow-up, 41 cases (42.3%, 41/97) had a poor outcome. Multiple Logistic regression analysis showed that post-stroke SIRI(Or=4.71, 95% CI:1.24-17.90) and SII(Or=3.13, 95% CI:0.88-11.06) were correlated with poor outcomes within 90 days after the stroke. Analysis using restricted cubic splines showed that as the levels of SIRI and SII increased, the risk of poor outcomes in patients with in-hospital symptomatic stroke increased. Conclusions SIRI is an independent risk factor for poor outcomes in patients with in-hospital symptomatic stroke, and the risk of poor neurological outcomes increases with high level of SIRI.

Key words: in-hospital stroke, systemic inflammatory response syndrome, systemic immune-inflammation index, national institute of health stroke scale, poor prognosis.

中图分类号:

R741

李楠, 张贵涛, 王彬, 冯瑶, 李淑娟, 周瑛华. 炎性反应相关指标与院内症状性卒中患者不良预后相关[J]. 基础医学与临床, 2025, 45(8): 1083-1087.

LI Nan, ZHANG Guitao, WANG Bin, FENG Yao, LI Shujuan, ZHOU Yinghua. Correlation between inflammatory response-related indicators and poor outcomes of in-hospital patients with symptomatic stroke[J]. Basic & Clinical Medicine, 2025, 45(8): 1083-1087.

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炎性反应相关指标与院内症状性卒中患者不良预后相关

Correlation between inflammatory response-related indicators and poor outcomes of in-hospital patients with symptomatic stroke

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