细胞外水分比率对急性缺血性卒中患者出院结局的影响 Effects of the Ratio of Extracellular Water to Total Body Water on Discharge Outcomes in Patients with Acute Ischemic Stroke

Abstract

目的 探讨细胞外水分比率（ratio of extracellular water to total body water，ETR）对急性缺血性卒中（acute ischemic stroke，AIS）患者出院结局的影响。 方法 回顾性分析2018年7月—2024年6月在北京市房山区良乡医院神经内科住院的AIS患者，根据出院结局将患者分为结局良好（mRS评分＜3分）组和结局不良（mRS评分≥3分）组。比较两组患者的临床资料和ETR等指标的差异，采用多因素logistic回归分析探讨ETR对患者出院结局的影响，并在不同性别、年龄、BMI、骨骼肌质量指数及入院NIHSS评分亚组中分析ETR对出院结局的影响。 结果 共纳入AIS患者147例，平均年龄（68.9±12.2）岁，其中男性80例（54.4%），结局良好组107例（72.8%），结局不良组40例（27.2%）。多因素logistic回归分析显示，ETR升高（OR 2.09，95%CI 1.16～3.76，P=0.014）和ETR≥40.0%（OR 6.24，95%CI 1.33～29.32，P=0.020）是AIS患者出院结局不良的危险因素。亚组分析结果稳健，无明显交互作用（P交互＞0.05）。在年龄＜71岁、BMI≥24 kg/m2以及入院NIHSS评分≥3分亚组中，ETR对出院结局不良的影响具有显著性。 结论 ETR是AIS患者出院结局的独立影响因素，高ETR可显著增加出院结局不良的风险。 Abstract: Objective To investigate the effects of the ratio of extracellular water to total body water (ETR) on discharge outcomes in patients with acute ischemic stroke (AIS). Methods Patients with AIS who were hospitalized in the Neurology Department, Liangxiang Hospital of Beijing Fangshan District, from July 2018 to June 2024 were retrospectively analyzed. They were divided into two groups based on their discharge outcomes: the good outcome (mRS score＜3 points) group and the poor outcome (mRS score≥3 points) group. Differences in clinical data and indicators like ETR were compared between the two groups. Multivariate logistic regression analysis was used to explore the effect of ETR on patient discharge outcomes. Furthermore, subgroup analyses were conducted to evaluate ETR’s effect on discharge outcomes by sex, age, BMI, skeletal muscle index, and admission NIHSS score. Results A total of 147 AIS patients were included, with an average age of (68.9±12.2) years, including 80 males (54.4%), 107 cases (72.8%) in the good outcome group, and 40 cases (27.2%) in the poor outcome group. Multivariate logistic regression analysis showed that increased ETR (OR 2.09, 95%CI 1.16-3.76, P=0.014) and ETR≥40.0% (OR 6.24, 95%CI 1.33-29.32, P=0.020) were risk factors for poor discharge outcomes in patients with AIS. The subgroup analysis results remained robust with no significant interaction (Pinteraction＞0.05). In the subgroup of patients with age<71 years, BMI≥24 kg/m2, and admission NIHSS score≥3 points, the effect of ETR on poor discharge outcomes was significant. Conclusions ETR is an independent factor influencing discharge outcomes in patients with AIS, and high ETR can significantly increase the risk of poor discharge outcomes.

Keywords

• 急性缺血性卒中
• 生物电阻抗分析
• 细胞外水分比率
• 出院结局
• acute ischemic stroke
• bioelectrical impedance analysis
• ratio of extracellular water to total body water
• discharge outcome