血清前白蛋白与脑出血预后的相关性研究

Correlation of serum prealbumin with functional outcome of cerebral hemorrhage

目的 探讨血清前白蛋白水平与脑出血患者预后的相关性。方法 纳入自发性脑出血患者31例,收集临床资料,在入院24 h内采集空腹血检测血清前白蛋白水平。采用美国国立卫生研究院卒中量表（National Institutes of Health Stroke Scale,NIHSS）对入院时的神经功能缺损严重程度进行评定,在发病后第90天应用改良Rankin量表（modified Rankin Scale,mRS）评价患者功能预后,根据第90天mRS将患者分为预后良好组（0-2分）和预后不良组（3-6分）。结果 在31例自发性脑出血患者中,预后良好组21例（67.7%）,预后不良组10例（32.3%）。与预后不良组比较,预后良好组患者入院时前白蛋白（prealbumin,PA）水平较高,而NIHSS评分和低密度脂蛋白胆固醇（low density lipoprotein cholesterol,LDL-C）水平较低。二元Logistic回归分析结果显示,高基线NIHSS评分、低血清前白蛋白水平是脑出血患者预后不良的独立危险因素;随着基线NIHSS评分的增高,患者预后不良的趋势增加（OR 1.333,95%CI 1.023-1.738;P=0.033）;血清前白蛋白水平增高,患者预后不良的趋势降低（OR 0.972,95%CI 0.946-0.998;P=0.039）。结论 在预后不良的患者中血清前白蛋白水平明显降低,血清前白蛋白水平是自发性脑出血患者预后不良的独立危险因素。

Objective The aim of this study was to determine whether the serum prealbumin level was associated with the functional outcome of cerebral hemorrhage .Methods A total number of 31 patients with spontaneous intracerebral hemorrhage were recruited;baseline data were recorded at admission and serum prealbumin was detected within 24 hours af-ter admission.The National Institutes of Health Stroke Scale （NIHSS） was used to evaluate the severity of neurological defi-cits and the modified Rankin Scale （mRS） to evaluate the clinical outcome at 90th day after onset.Patients were divided in-to a good outcome group （mRS 0-2） and a poor outcome group（mRS 3-6）.Results Of the 31 spontaneous intracere-bral hemorrhage patients included,21（67.7%） were in the good outcome group,and 10 （32.3%） in the poor outcome group.Compared with the poor outcome group ,theserum prealbumin was higher ,the NIHSS and LDL-C at admission were lower in the good outcome group .Binary logistic analysis showed that high baseline NIHSS and low serum prealbumin were independent risk predictors for poor outcome of spontaneous intracerebral hemorrhage ;the trend of poor outcome was in-creased with the increasing of baseline NIHSS （OR 1.333, 1.023-1.738 95%CI;P=0.033） and decreased with the ele-vated level of prealbumin （OR 0.972,95%CI 0.946-0.998;P=0.039）.Conclution The serum prealbumin level de-creases in the poor outcome group of spontaneous intracerebral hemorrhage .The low serum prealbumin level is an independ-ent risk factor for poor outcome in patient with spontaneous intracerebral hemorrhage .