急性脑出血患者C反应蛋白和白蛋白比值与30天格拉斯哥预后评分的关联评估  

Association of CRP/Alb ratio and 30-day GOS score in patients with acute cerebral hemorrhage

作　　者：王瑾[1] 刘晶[1] 刘文艳 袁毓 洪军[1] Wang Jin;Liu Jing;Liu Wenyan;Yuan Yu;Hong Jun(Second Department of Neurosurgery,Tangshan Workers􀆳Hospital,Tangshan 063000,Hebei Province,China)

机构地区：[1]唐山工人医院神经外二科,063000

出　　处：《中华老年心脑血管病杂志》2023年第1期44-47,共4页Chinese Journal of Geriatric Heart,Brain and Vessel Diseases

基　　金：河北省卫生和计划生育委员会科研基金项目(20201513)。

摘　　要：目的探讨急性脑出血患者C反应蛋白/白蛋白(CRP/Alb)比值与30 d格拉斯哥预后评分(GOS)的关联。方法选取2018年5月至2020年5月唐山工人医院收治的260例急性脑出血患者,治疗30 d后采用GOS评估短期预后情况,将患者分为预后良好组(GOS>3分)195例和预后不良组(GOS≤3分)65例,比较2组患者入院时即距离发病12 h以内(T1)、距离发病24~48 h(T2)、距离发病5~7 d(T3)各时间点CRP/Alb比值水平。采用美国国立卫生研究院卒中量表(NIHSS)评分,将患者分为早期神经功能恶化组(恶化组)93例和早期神经功能非恶化组(非恶化组)167例,比较恶化组与非恶化组不同时间点的CRP/Alb比值水平。采用logistic回归分析不同早期神经功能恶化程度、不同时间点CRP/Alb比值的关联。结果预后不良组年龄、既往脑卒中史、CRP、CRP/Alb比值、入院时NIHSS评分显著高于预后良好组,Alb、入院时GOS评分、住院期间感染显著低于预后良好组,差异有统计学意义(P<0.05,P<0.01)。重复测量方差分析显示,不同时间点CRP/Alb比值比较有显著差异(P<0.05),各时间点预后良好组CRP/Alb比值显著高于预后不良组(P<0.05);恶化组与非恶化组不同时间点CRP/Alb比值比较有显著差异(P<0.05),且非恶化组各时间点CRP/Alb比值显著高于恶化组(P<0.05)。多因素logistic回归分析显示,T2时CRP/Alb比值(OR=1.261,95%CI:1.027~1.549,P=0.027)、早期神经功能恶化(OR=1.176,95%CI:1.062~1.302,P=0.002)是急性脑出血30 d预后不良的独立危险因素。结论CRP/Alb比值降低与急性脑出血患者病情及预后密切相关,监测CRP/Alb比值变化可为病情及评估提供重要参考依据。Objective To investigate the association between the ratio of C-reactive protein to albumin(CRP/Alb)and 30-day Glasgow Outcome Scale(GOS)score in patients with acute cerebral hemorrhage.Methods A total of 260 inpatients with acute cerebral hemorrhage admitted to our hospital from May 2018 to May 2020 were recruited in this study.In 30 d after treatment,GOS was used to evaluate the short-term prognosis of the patients,and then the patients were divided into good prognosis group(GOS score>3,n=195)and poor prognosis group(GOS score≤3,n=65).The serum levels of CRP and Alb were detected,and the CRP/Alb ratios at time of admission(within 12 h from the onset,T1),24 to 48 h from the onset(T2),and 5-7 d from onset were compared between the 2 groups.According to their neurological function by National Institutes of Health Stroke Scale(NIHSS)at adminssion,the patients were divided into early neurological deterioration group(93 cases)and early neurological non-deterioration group(167 cases).The CRP/Alb ratios at above time points were compared between the 2 groups.Logistic regression analysis was used to analyze the association of severity of early neurological deterioration and CRP/Alb ratio at different time points.Results Older age,history of stroke,and higher CRP level,CRP/Alb ratio and NIHSS score at admission,while lower Alb level,GOS score at admission and infectious rate during hospitalization were observed in the poor prognosis group when compared with the good prognosis group(P<0.05,P<0.01).Repeated measures ANOVA showed that there were significant differences in the CRP/Alb ratio at different time points(P<0.05),the ratio was significantly higher in the good than the poor prognosis groups at each time point(P<0.05);Obvious differences were seen in the CRP/Alb ratio at different time points between the neurological deterioration and non-deterioration group(P<0.05),and the latter group had higher CRP/Alb ratio at each time point(P<0.05).Multivariate logistic regression analysis indicated that CRP/Alb ratio at T2(O

关 键 词：脑出血 C反应蛋白质 白蛋白类 炎症 

分 类 号：R743.34[医药卫生—神经病学与精神病学]