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目的:探讨急性缺血性脑卒中患者血清肌钙蛋白-T(cTnT)水平升高与卒中严重程度和预后的关系。方法:123例急性缺血性脑卒中患者,在住院的第一天内完成血清cTnT水平的检查。以0.5ng/ml为界,将患者分为cTnT水平升高组和cTnT水平正常组。患者预后评价采用出院时mRS评分。结果:16例(13.0%)血清cTnT水平升高。与cTnT水平正常组相比,cTnT水平升高组患者入院时NIHSS评分更严重,岛叶受累的发生率更高,梗死体积大,预后较差。cTnT水平升高和入院时NIHSS评分(>14)预测卒中预后mRS评分(>4)特异性分别为93%和95%(P>0.05),敏感性分别为31%和82%(P<0.05)。结论:血清cTnT水平升高的急性缺血性中风患者卒中更严重,梗死体积大,预后较差,这些患者大多岛叶受累。cTnT水平升高作为一个预后预测指标的敏感性明显低于入院时NIHSS评分。
Objective: To investigate the relationship between serum cTnT level and stroke severity and prognosis in patients with acute ischemic stroke. Methods: 123 patients with acute ischemic stroke were examined for serum cTnT levels on the first day of hospitalization. Patients were divided into normal cTnT group and normal cTnT group according to 0.5ng / ml. Patient prognosis was assessed using mRS at discharge. Results: Serum cTnT level was increased in 16 cases (13.0%). Compared with the normal cTnT group, NIHSS scores were more severe at hospital admission, with a higher incidence of insula involvement, a larger infarct size, and a poorer prognosis than patients with elevated cTnT levels. The NIHSS score (> 14) at hospital admission was associated with a 93% and 95% improvement in mRS score (P> 0.05) for stroke prognosis and sensitivities of 31% and 82%, respectively (P <0.05 ). CONCLUSIONS: Acute ischemic stroke patients with elevated serum levels of cTnT have more severe strokes, larger infarct volumes, and poorer prognosis, with involvement of most of the islets in these patients. The sensitivity of elevated cTnT as a predictor of outcome was significantly lower than the NIHSS score at admission.