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目的探索急性缺血性脑卒中患者胆红素水平对美国国立卫生研究院卒中量表(national institute of health stroke scale,NIHSS)评分及预后的影响。方法选取2015年6—12月在运城市中心医院神经内科住院的缺血性脑卒中患者76例作为研究组,按照胆红素水平四分位间距分为四个亚组,选取同期非卒中患者31例作为对照组。分析患者胆红素水平及入院、出院NIHSS评分间的关系。计量资料采用t检验或方差分析,P<0.05为差异有统计学意义。结果研究组患者总胆红素、直接胆红素、间接胆红素水平分别为(12.70±5.88)、(4.22±2.20)、(8.48±4.21)μmol/L,均高于对照组的(9.90±3.07)、(3.06±1.46)、(6.84±2.39)μmol/L,差异均有统计学意义(均P<0.05)。不同总胆红素、直接胆红素、间接胆红素水平患者入院、出院NIHSS评分及NIHSS好转率比较,差异均有统计学意义(均P<0.05)。结论急性缺血性脑卒中患者胆红素代偿性增高,且对患者病情严重程度和预后均存在影响。
Objective To explore the impact of bilirubin levels in patients with acute ischemic stroke on the score and prognosis of the National Institutes of Health Stroke Scale (NIHSS). Methods Sixty-six patients with ischemic stroke hospitalized in Department of Neurology, Yuncheng Central Hospital from June to December in 2015 were selected as the study group, divided into four subgroups according to the bilirubin interquartile range, and the non-stroke patients 31 cases as control group. Analysis of patients with bilirubin levels and hospital discharge, NIHSS score between the relationship. Measurement data using t test or analysis of variance, P <0.05 for the difference was statistically significant. Results The levels of total bilirubin, direct bilirubin and indirect bilirubin in the study group were (12.70 ± 5.88), (4.22 ± 2.20) and (8.48 ± 4.21) μmol / L, respectively, higher than those in the control group (9.90 ± 3.07), (3.06 ± 1.46) and (6.84 ± 2.39) μmol / L, respectively (all P <0.05). There were significant differences in NIHSS scores and NIHSS improvement rates between patients with different total bilirubin, direct bilirubin and indirect bilirubin (all P <0.05). Conclusions Patients with acute ischemic stroke have bilirubin compensatory increase, and have an impact on the severity and prognosis of patients.