C-反应蛋白/白蛋白比值与缺血性脑卒中预后的关系

The Relationship Between C-reactive Protein/Albumin Ratio and Prognosis of Ischemic Stroke

目的探究C-反应蛋白/白蛋白比值与缺血性脑卒中预后的关系。方法选取本院2017年5月至2019年2月收治的缺血性脑卒中患者152例作为研究对象设为研究组,同时选择80例健康者作为对照组。用改良Rankin量表(modified Rankin scale,mRS)评分来评估患者神经功能缺损程度,并根据评分结果将患者分为预后良好组(mRS评分为0~2分)100例和预后不良组(mRS评分为3~5分)52例,分别测定并比较不同组别患者血清C-反应蛋白/白蛋白比值,通过研究对象工作特征曲线(receiver operating characteristic curve,ROC)和曲线下面积(area under the curve,AUC)来评价C-反应蛋白/白蛋白比值在缺血性脑卒中患者预后评估中的价值,并对影响患者预后的相关因素采用Logistic回归分析。结果预后良好和预后不良组患者性别、年龄、吸烟、高血压病史、收缩压及舒张压等比较差异无统计学意义(P>0.05);但预后不良组患者美国国立卫生研究院卒中量表(National Institute of Health stroke scale,NIHSS)评分、血清C-反应蛋白、血清C-反应蛋白/白蛋白比值均明显高于预后良好组(P<0.05),血清白蛋白水平低于预后良好组(P<0.05);经ROC曲线分析结果显示血清C-反应蛋白/白蛋白比值AUC为0.743(95%CI:0.655~0.831),截断值为0.288,此时对应的灵敏度及特异性分别为67.3%,75%;Logistic回归分析结果显示NIHSS评分(OR=1.818,95%CI:1.032~3.201,P<0.05)、C-反应蛋白水平(OR=2.522,95%CI:2.034~3.125,P<0.05)及C-反应蛋白/白蛋白比值(OR=2.412,95%CI:1.385~4.201,P<0.05)是缺血性脑卒中患者预后不良的独立危险因素。结论血清C-反应蛋白/白蛋白比值在缺血性脑卒中患者不良预后中明显升高,可作为缺血性脑卒中患者预后评估中的标志物,有助于判断患者的预后,具有较高的临床推广应用价值。

Objective To explore the relationship between C-reactive protein/albumin ratio and prognosis of ischemic stroke.Methods 152 patients with ischemic stroke admitted to our hospital from May,2017 to February,2019 were selected as the study group,while 80 healthy people were selected as the control group.The degree of neurological deficit was assessed by modified Rankin scale(mRS).According to the score,the patients were divided into the good prognosis group with 100 cases(mRS score 0-2)and the poor prognosis group with 52 cases(mRS score 3-5).Serum C-reactive protein/albumin ratio was measured and compared across different groups.The value of C-reactive protein/albumin ratio in prognosis of patients with ischemic stroke was evaluated by receiver operating characteristic curve(ROC)and the area under the curve(AUC),also logistic regression analysis was used to analyze the prognostic factors.Results There were no significant differences in sex,age,smoking,history of hypertension,systolic blood pressure and diastolic blood pressure between the two groups(P>0.05).However,National Institute of Health stroke scale(NIHSS)score,serum C-reactive protein,serum C-reactive protein/albumin ratio in the poor prognosis group were significantly higher than those in the good prognosis group(P<0.05),and serum albumin level was lower than those in the good prognosis group(P<0.05).The results of ROC curve showed that the AUC value of serum C-reactive protein/albumin ratio was 0.743(95%CI:0.655-0.831),the truncation value was 0.288,and the corresponding sensitivity and specificity were 67.3%and 75%,respectively.Logistic regression analysis showed that NIHSS score(OR=1.818,95%CI:1.032-3.201,P<0.05),C-reactive protein level(OR=2.522,95%CI:2.034-3.125,P<0.05)and C-reactive protein/albumin ratio(OR=2.412,95%CI:1.385-4.201,P<0.05)were independent risk factors for poor prognosis of patients with ischemic stroke.Conclusion The serum C-reactive protein/albumin ratio increases significantly in the adverse prognosis of patients with ischemic stroke.It can be used as a marker in the prognosis evaluation of patients with ischemic stroke,further help to judge the prognosis of patients,indicating a high clinical application value.