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[目的]探讨脑脊液(cerebrospinal fluid,CSF)中游离脂肪酸(free fatty acid,FFA)水平在急性缺血性脑卒中(Acute ischemic stroke,AIS)患者中的预后价值.[方法]选取2012年1月至2015年12月本院收治的321例AIS患者为研究对象.在入院时采用美国国立卫生研究院卒中量表(NIHSS)对患者卒中程度进行评分,同时检测患者脑脊液及血清中FFA水平,90 d后对患者采用改良Rankin量表(mRS)对患者预后进行评价,并分析FFA在AIS患者中的预后价值.[结果]231例预后良好的患者CSF及血清中FFA的水平明显低于90例预后不良的患者,而272例生存患者CSF及血清中FFA的水平明显低于49例死亡患者,差异均具有统计学意义(P＜0.05).CSF中FFA的水平与NIHSS评分及卒中患者脑梗死病灶体积呈明显的正相关,且脑脊液中FFA水平与血清中FFA水平也呈正相关.多因素Logistic分析结果显示,CSF中FFA水平超过0.301 mmol/L时,患者预后不良的风险增加(OR=5.28,P＜0.0001).[结论]急性缺血性脑卒中患者入院早期CSF中FFA水平可以作为一个独立的短期预后指标对患者的预后进行评价.“,”[Objective]To evaluate the prognostic value of free fatty acid (FFA) levels in cerebrospinal fluid (CSF) of patients d with acute ischemic stroke (AIS).[Methods]A total of 321 cases of acute ischemic stroke patients from January 2012 to December 2015 in our hospital were selected as study subjects.The National Institutes of Health Stroke Scale (NIHSS) score on admission was applied to assess specific severity degree of stroke.The levels of FFA from CSF and serum were measured using an enzyme cycling method.The prognostic outcomes of those stroke patients were evaluated by the modified Rankin scale scores 90days after admission.The prognostic value of FFA was analyzed by Logistic regression analysis.[Results]There was a positive relationship between CSF FFA and NIHSS score.Additionally,there was a positive relationship between the severity of stroke and serum levels of FFA.The FFA levels of CSF and serum in 231 patients with favorable outcome were significantly lower than those in 90 patients with unfavorable outcomes(P ＜ 0.05).The FFA levels of CSF and serum in 272 cases of survival patients were significantly lower than those in 49 dead patients (P ＜0.05).Multivariate analysis results showed that there was an increased risk of unfavorable outcome associated with FFA level in CSF ≥0.301 mmol/L(OR=5.28,P ＜0.0001).[Conclusion]The FFA level in CSF at admission was suggested to be an independent short-term prognostic marker in patient with AIS.