Explorationof the OptimalCut-off Valuesof HcyandNT-proBNPforPredicting thePrognosis of Ischemic Stroke inDifferent Age Groups/ ， ，，.//Medical Innovation of China，2025，22（16）：147-151

[Abstract]Objective： To explore the optimalcut-off values of homocysteine （Hcy）and N-terminal pro-BNP （NT-proBNP）for predictingthe prognosis of ischemic stroke indiffrent age groups.Method： A total of1OO patients with ischemic stroke who were treated at Pingxiang City Anyuan District People's Hospital and Pingxiang Xiangdong District People's Hospital from January to December 2O24 were selected as the study subjects.According to the modified Rankin scale （mRS） scores，they were divided into favorable prognosis group （mRS score ⩽2 scores） and poor prognosis group （mRS score ≥3 scores）.Their general information and test results of Hcy and NT-proBNP were collected.The patients were divided into agelt;65 years groupand age≥65 years group.Univariateand multivariate logistic regresson analyses were performed.ROCcurves were plotted to analyze theoptimal cut-off values of Hcy， NT-proBNPfor predicting the prognosis of ischemic stroke in different age groups.Result： Among 10O patients with ischemic stroke， 62 cases （62.00% ）and 38 cases （ 38.00% ）were included in the favorable prognosis group and the poor prognosis group，respectively. Among 47 cases in the age lt;65 years group，there were 35 cases with favorable prognosis and 12 cases with por prognosis. Among 53 cases in the age ≥65 years group，there were 27cases with favorable prognosis and 26 cases with poor prognosis.There were statistically significant differences inage，the type of cerebral ischemia，and hypertension history between the poor prognosis group and the favorable prognosis group in both the age lt;65 years group and the age ⩾ 65 years group （ P lt;0.05）. The levels of Hcy and NT-proBNP in the poor prognosis group were higher than those in the good prognosis group （ Plt;0.05） . Multivariate logistic regression analysis foundthatage，HcyandNT-proBNPlevels were independent risk factors affecting the prognosis of ischemic stroke inboth the age lt;65 years group and theage ≥65 years group （Plt;0.05） .ROCcurveanalysisshowed that the optimal cut-off values of Hcy and NT-proBNPfor predicting the prognosis in the age lt;65 years group were 27.56 μmol/L and 634.95pg/mL ，which were higher than those in the age ≥65 years group （21.87 μmol/L and （20 580.22pg/mL ）.Both demonstrated certain value in prediction. Conclusion： Hcyand NT-proBNP are closely related totheprognosisofischemicstroke.Besides，theoptimalcut-offvaluesofthetwoindexesforpredicting theprognosis in youngand middle-aged patientsare higherthanthose intheelderly.Itis recommended toconductindividualized monitoringbased onpatient age inclinical practice.

[Keywords]Ischemic strokeHcyNT-proBNPOptimal cut-off values

First-author'saddress：Clinical Laboratory，Pingxiang CityAnyuan DistrictPeople'sHospital， ingxiang 337000， China

doi：10.3969/j.issn.1674-4985.2025.16.035

缺血性脑卒中是由于脑部血液供应障碍，缺血、缺氧导致局部脑组织坏死或软化。患者会出现肢体无力、言语障碍、口角歪斜等症状，该病具有高发病率、高致残率和高死亡率的特点，对患者的生活质量影响巨大[3-4]。因此，探寻有效的预测指标对于缺血性脑卒中预后的评估具有极为重要的意义。同型半胱氨酸（Hcy）近年来在心血管疾病研究领域备受关注[，它与血管内皮损伤、血栓形成等病理过程密切相关，可能在缺血性脑卒中的发生发展及预后中发挥关键作用。N末端脑钠肽前体（NT-proBNP）则主要反映心脏功能状态[，在心血管疾病的诊断与预后判断方面已被广泛应用，在缺血性脑卒中患者中也可能因心脏应激反应等因素而出现变化，进而影响患者的整体预后[8]。但Hcy、NT-proBNP与缺血性脑卒中的预后关系尚缺乏足够的循证医学证据支持，尤其针对不同年龄段缺血性脑卒中人群预后预测价值的对比研究较为匮乏。基于此，本研究对不同年龄组的缺血性脑卒中患者Hcy与NT-proBNP进行检测分析，分析其预测不同年龄分层患者最佳切点值，为临床治疗、预后提供参考。

1资料与方法

1.1一般资料

选取2024年1—12月于萍乡市安源区人民医院、萍乡市湘东区人民医院接受治疗的100例缺血性脑卒中患者，纳入标准：（1）符合文献[9]《各类脑血管疾病诊断要点》诊断标准；（2）经影像学检查确诊为缺血性脑卒中；（3）病历资料完整。排除标准：（1）合并其他脑部疾病；（2）存在严重心肺功能衰竭；（3）肝肾功能不全；……