Study on the value of systemic immune-inflammation index in predicting short-term functional prognosis of patients with a-cute cerebral infarction
Objective To investigate the value of systemic immune-inflammation index(SII)in predicting short-term functional prognosis of acute cerebral infarction patients with thrombolysis.Methods Patients with acute cerebral infarction who were hospital-ized in the Department of Neurology,Xishan People's Hospital of Wuxi from January 2022 to December 2023 and received intrave-nous thrombolytic therapy with Alteplase(rt-PA)within 4.5 hours of onset were retrospectively collected as the study objects,and the relevant clinical data were collated.According to the modified Rankin Scale(mRS)score at discharge,all enrolled patients were di-vided into the good prognosis group(mRS ≤2 points)and the poor prognosis group(mRS＞2 points).The changes of neutrophils,platelets,lymphocytes and other indicators in the baseline(before thrombolysis)and 24 hours after thrombolysis of patients in the two groups were recorded,and SII results were obtained.Receiver operating characteristic(ROC)curves were used to evaluate the value of SII in predicting short-term prognosis of thrombolysis patients with acute cerebral infarction.Results A total of 174 subjects were included in this study,including 127 in the good prognosis group and 47 in the poor prognosis group.Compared with the good progno-sis group,the proportion of atrial fibrillation,hypertension and hemorrhage in the poor prognosis group was higher.Age,National Insti-tutes of Health Stroke Scale score(NIHSS)before and after thrombolysis,baseline systolic blood pressure,fasting blood glucose,gly-cated hemoglobin and D-dimer levels in the poor prognosis group were significantly higher than those in the good prognosis group(P＜0.05).There was no significant difference in baseline SII between the two groups(P=0.268).The level of SII in the poor prognosis group was significantly higher than that in the good prognosis group at 24 hours after thrombolysis(P＜0.001).ROC curve analysis showed that SII after thrombolysis was one of the independent influencing factors for poor prognosis in patients with acute cerebral infarction.The optimal cut-off value was 753.68,the area under the curve was 0.821(95％CI 0.746～0.896,P＜0.01),the maximum approximate entry index was 0.620,the sensitivity was 87.2％,and the specificity was 74.8％.The area under the curve of post-thrombolytic NIHSS score and combined with post-thrombolytic SII were 0.894 and 0.945,respectively,and the sensi-tivity were 78.7％and 93.6％,respectively.The specificity was 87.4％and 88.2％,respectively.Conclusion The increase of SII after thrombolysis is associated with poor short-term prognosis in patients with acute cerebral infarction.Dynamic monitoring of SII within 24 hours after thrombolysis has certain predictive value for short-term functional prognosis in patients with acute cerebral in-farction.
万方数据
维普
