关键词: 急性缺血性脑卒中, 共病状态, 预后, CIRS评分, NIHSS评分, mRS评分

Abstract: Background　A large number of clinical diagnosis results show that middle-aged and elderly patients with acute ischemic stroke suffer from a variety of chronic diseases at the same time，and this co-disease state has a great impact on the recovery of prognostic function of patients.Objective　To investigate the relationship between comorbidity and the National Institutes of Health Stroke Scale（NIHSS） scores and modified Rankin Scale（mRS） scores after three months in middle-aged and elderly patients with acute ischemic stroke.Methods　Information of 293 patients with acute ischemic stroke aged 45 and over who were hospitalized in the Department of Neurology in Wenjiang District People's Hospital from January 2016 to June 2018 were prospectively collected，including their clinical information，Cumulative Illness Rating Scale（CIRS） scores，comorbidity index，severity index，NIHSS scores at admission and discharge（the discharge NIHSS score was 0 to 2 points or decreased ≥4 points compared with the admission score, and the discharge score was improved），and mRS scores after three months（mRS score ≤2  after three months discharge was considered as a good prognosis）.The relationship between comorbidity and functional recovery at follow-up after three months of discharge was analyzed.Results　The average CIRS score was（9.58±5.04）；the severity index was（0.67±0.36）；the comorbidity index was（3.30±1.83）；and the scores of admission NIHSS and discharge NIHSS were 6（4，11） and 3（1，8） respectively.The age，severity index，comorbidity index，admission NIHSS score，discharge NIHSS score，length of stay，and mRS score of the stratified patients with different CIRS scores showed statistically significant differences（P<0.05）.Stratified comparison of CIRS scores of patients with different discharge improvement conditions showed statistically significant difference（P<0.05）.CIRS score stratification，age，severity index，comorbidity index，discharge NIHSS score and length of hospital stay of patients with different prognosis showed statistically significant differences（P<0.05）.NIHSS scores at discharge and admission，severity index，the CIRS scores，atrial fibrillation，comorbidity index，age and hospitalization time were positively correlated with mRS scores after thee months．Hypertension was negatively correlated with mRS scores after thee months（P<0.05）.Conclusion　There is a significant relationship between comorbidity and NIHSS scores at discharge and mRS scores after three months in middle-aged and elderly patients with acute ischemic stroke.The patients who are younger with lower CIRS scores，comorbidity index and severity index have a good prognosis.

Key words: Acute ischemic stroke, Comorbidity, Prognosis, CIRS score, NIHSS score, mRS score