血清IL-6与hs-CRP对老年急性缺血性脑卒中合并重症肺炎患者预后的影响OA
Impact of serum interleukin-6 and high-sensitivity C-reactive protein on the prognosis of elderly patients with acute ischemic stroke and severe pneumonia
目的 探究血清白细胞介素-6(IL-6)与超敏C反应蛋白(hs-CRP)对老年急性缺血性脑卒中(AIS)合并重症肺炎(SP)患者预后的影响.方法 选取2022年1月—2025年3月洛阳市中心医院收治的老年AIS合并SP患者172例作为研究对象,根据90 d随访结果分为预后不良组(死亡)、预后良好组(存活).收集并比较两组血清IL-6、hs-CRP水平及一般资料;采用多因素Logistic回归分析老年AIS合并SP患者预后的影响因素;通过受试者工作特征曲线(ROC)评估IL-6、hs-CRP单独及联合应用,以及年龄、美国国立卫生院脑卒中量表(NIHSS)评分对老年AIS合并SP患者预后的预测价值.结果 172例患者随访90 d,失访10例,其余162例死亡率38.89%;预后不良组血清IL-6、hs-CRP水平均高于预后良好组(P<0.05);多因素Logistic回归显示,年龄较大(OR=2.105,95%CI 1.142～3.880)、NIHSS评分较高(OR=3.259,95%CI 1.469～7.229)、合并吞咽障碍(OR=2.317,95%CI 1.344～3.995)、IL-6高水平(OR=2.862,95%CI 1.435～5.707)以及hs-CRP高水平(OR=3.834,95%CI 1.656～8.874)是老年AIS合并SP患者预后不良的危险因素(P<0.05);ROC曲线显示,IL-6、hs-CRP预测老年AIS合并SP患者预后不良的曲线下面积(AUC)均高于年龄与NIHSS评分;Pairwise算法检验显示,IL-6联合hs-CRP预测老年AIS合并SP患者预后不良的AUC均高于两者单独预测(Z=2.663,P=0.007 7;Z=2.197,P=0.028).结论 年龄、NIHSS评分、合并吞咽障碍、IL-6及hs-CRP是老年AIS合并SP患者预后的独立危险因素,IL-6联合hs-CRP对老年AIS合并SP患者预后不良具有较高的预测价值.
Objective To investigate the impact of serum interleukin-6(IL-6)and high-sensitivity C-reactive pro-tein(hs-CRP)on the prognosis of elderly patients with acute ischemic stroke(AIS)and severe pneumonia(SP).Methods A total of 172 elderly patients with AIS and SP who were admitted to our hospital from January 2022 to March 2025 were enrolled,and according to their 90-day follow-up results,they were divided into death group and survival group.The two groups were compared in terms of the serum levels of IL-6 and hs-CRP and general information;a multi-variate logistic regression analysis was used to identify independent influencing factors for the prognosis of elderly patients with AIS and SP;the receiver operating characteristic(ROC)curve analysis was used to evaluate the value of IL-6 and hs-CRP used alone or in combination,as well as age and National Institutes of Health Stroke Scale(NIHSS)score,in predict-ing the prognosis of patients with AIS and SP.Results Among the 172 patients after follow-up for 90 days,10 were lost to follow-up,and the remaining 162 patients had a 90-day mortality rate of 38.89%.The death group had significantly higher serum levels of IL-6 and hs-CRP than the survival group(P<0.05).The multivariate logistic regression analysis showed that an older age(OR=2.105,95%CI 1.142‒3.880,P<0.05),an increase in NIHSS score(OR=3.259,95%CI 1.469-7.229,P<0.05),the presence of dysphagia(OR=2.317,95%CI 1.344‒3.995,P<0.05),and an increase in IL-6(OR=2.862,95%CI 1.435‒5.707,P<0.05),and an increase in hs-CRP(OR=3.834,95%CI 1.656‒8.874,P<0.05)were risk factors for poor prognosis in elderly patients with AIS and SP.The ROC curve analysis showed that IL-6 and hs-CRP had a larger area under the ROC curve(AUC)than age and NIHSS score in predicting poor prognosis in elderly pa-tients with AIS and SP,and pairwise comparisons showed that combined measurement of IL-6 and hs-CRP had a larger AUC than IL-6 or hs-CRP alone in predicting poor prognosis in elderly patients with AIS and SP(Z=2.663,P=0.0077;Z=2.197,P=0.028).Conclusion Age,NIHSS score,comorbid-ity with dysphagia,IL-6,and hs-CRP are independent risk factors for the prognosis of elderly patients with AIS and SP,and the combination of IL-6 and hs-CRP has a relatively high value in predicting poor prognosis in elderly patients with AIS and SP.
余鸽鸽;宋丁;阮春云;李文波;赵星鹏
洛阳市中心医院神经内科重症监护室,河南 洛阳 471000洛阳职业技术学院医学技术学院,河南 洛阳 471000洛阳市中心医院神经内科重症监护室,河南 洛阳 471000洛阳市中心医院神经内科重症监护室,河南 洛阳 471000洛阳市中心医院检验科,河南 洛阳 471000
医药卫生
白细胞介素-6超敏C反应蛋白卒中肺炎预后
Interleukin-6High-sensitivity C-reactive proteinStrokePneumoniaPrognosis
《中风与神经疾病杂志》 2026 (5)
436-442,7
2021年度河南省医学科技攻关计划联合共建项目(LHGJ20210843)
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