高海拔地区低白蛋白血症对首发急性脑梗死患者神经功能及短期预后的影响  

The Effect of Hypoalbuminemia on Neurologic Function and Short-term Prognosis in Patients with First Acute Cerebral Infarction at High Altitude

作　　者：黄茜[1] 李鹏轶 王文 李延红 Huang Qian;Li Pengyi;Wang Wen;Li Yanhong(Department of Neurology,Afflicated Hospital of Qinghai University,810001)

机构地区：[1]青海大学附属医院神经内科,810001

出　　处：《高原医学杂志》2020年第3期16-20,共5页Journal of High Altitude Medicine

摘　　要：目的:探讨高海拔地区低白蛋白血症对首发急性脑梗死患者神经功能及短期预后的影响。方法:选取2016年8月—2017年12月我院收治的115例急性脑梗死患者作为观察对象。根据入院后首次血清白蛋白水平分为低白蛋白组和对照组(正常白蛋白组)两组,比较两组患者入院时、第14天的NIHSS评分及mRS评分并对两组患者年龄、HbA1c、UA、TG、TC、LDL、HDL进行统计分析;最后根据NIHSS评分及mRS评分将低白蛋白组分为预后良好组及预后不良组再次进行比较。结果:对照组与低白蛋白组之间神经功能缺损程度(NIHSS评分)、预后(mRS)的关系比较,结果显示两组患者的入院时NIHSS评分、14天NIHSS评分、入院时mRS、14天mRS差异均有统计学意义(P<0.05);对照组与低白蛋白组之间TG、TC、HbA1c比较,差异均有统计学意义(P <0.05),同时低白蛋白组脑梗死患者年龄大于对照组,TG、TC均高于对照组;低白蛋白是影响急性脑梗死预后的独立因素(P <0.05)。结论:低白蛋白血症可加重急性重症脑梗死患者神经功能缺损程度,增加致残率,低蛋白血症患者通常年龄较大且合并有高甘油三酯、高胆固醇等脑血管病的危险因素,同时低蛋白血症是影响急性脑梗死患者预后的一个独立因素。Objective:The study is to explore the effect of hypoalbuminemia on neurologic function and short-term prognosis in patients with first acute cerebral infarction at high altitude.Methods:115 patients with acute cerebral infarction were selected as the research objects.According to the first serum albumin level after admission,the patients were divided into low albumin group and normal albumin group.NIHSS score and mRS score of the two groups were compared at admission time and on the 14 th day,whose age、HbA1 c、UA、TG、TC、LDL、HDL were statistically analyzed.According to NIHSS score and Mrs score,the low albumin group was divided into good prognosis group and poor prognosis group for comparison again.Results:The results showed that the NIHSS score at admission,NIHSS score at 14 days,MRS at admission and MRS at 14 days were significantly different between the two groups(P < 0.05).TG、TC、HbA1 c between the control group and the low albumin group were statistically different(P < 0.05).The age of patients with acute cerebral infarction was older than that of control group,TG and TC were higher than those of control group and low albumin was an independent factor affecting the prognosis of acute cerebral infarction(P < 0.05).Conclusion:Hypoalbuminemia can aggravate the neurological deficit and increase the disability rate in patients with acute severe cerebral infarction;the patients with hypoproteinemia are usually older and have high triglyceride,high cholesterol and other cerebrovascular disease risk factors.Meanwhile,hypoproteinemia is an independent factor affecting the prognosis of patients with acute cerebral infarction.

关 键 词：高海拔 急性脑梗死 低白蛋白血症 预后 

分 类 号：R743.33[医药卫生—神经病学与精神病学] R339.5+4[医药卫生—临床医学]