缺血性卒中急性期HALP评分与卒中后认知障碍相关性研究  

Correlation between HALP score in acute phase of ischemic stroke and post⁃stroke cognitive impairment

作　　者：周涛 戴莉莉 宋雨影 卡力比努尔·赛买提 哈斯也提·依不来音[1] ZHOU Tao;DAI Lili;SONG Yuying;KALIBINUER Saimaiti;HASIYETI Yibulaiyin(Department of Neurology,The Second Affiliated Hospital of Xinjiang Medical University,Urumqi 830000,China)

机构地区：[1]新疆医科大学第二附属医院神经内科,新疆乌鲁木齐830000

出　　处：《海南医学院学报》2024年第13期982-989,共8页Journal of Hainan Medical University

基　　金：新疆维吾尔自治区卫生健康扶贫工作优秀适宜技术推广项目新疆基层医院阿尔茨海默病的规范化诊治技术推广(SYTG‑Y201934)。

摘　　要：目的:近年来HALP评分(血红蛋白、白蛋白、淋巴细胞和血小板)作为衡量全身炎症和营养状况的新指标得到广泛关注。本研究旨在探讨HALP评分与急性缺血性卒中(acute ischemic stroke,AIS)患者卒中后认知障碍(post‑stroke cognitive impairment,PSCI)的关系及其预测价值。方法:选取本院220例首次发病的AIS患者,获得一般临床资料。根据蒙特利尔认知评估(Montreal Cognitive Assessment,MOCA)评分,将患者分为PSCI组和非PSCI组。HALP评分按公式计算:血红蛋白(g/L)×白蛋白(g/L)×淋巴细胞(/L)/血小板(/L),按三分位数分为3层。采用二元Logistic回归分析HALP与认知结果之间的关系。结果:PSCI组的HALP评分明显低于非PSCI组(P<0.001)。HALP评分被分为T1≤33.90、T233.90~53.75、T3>53.75三层。在二元逻辑回归分析中,以T3层为参考,调整混杂因素后T1层[OR=9.38,95%CI=1.93~45.95,P=0.006],而T2层PSCI风险没有增加[OR=1.52,95%CI=0.58~4.02,P=0.393]。结论:AIS的HALP评分与PSCI相关,此外HALP评分对PSCI有诊断价值。Objective:In recent years,the HALP score(calculated as the product of hemoglobin,albumin,lymphocytes,and platelets)has gained wide attention as a new indicator for assessing systemic inflammation and nutritional status.This study aims to investigate the relationship between the HALP score and post‑stroke cognitive impairment(PSCI)in patients with acute ischemic stroke(AIS),as well as its predictive value.Methods:A total of 220 AIS patients were enrolled,and their general clinical data were collected.Based on the Montreal Cognitive Assessment(MOCA)scores,patients were categorized into the PSCI and the post‑stroke non‑cognitive impairment(PSNCI)groups.The HALP score was calculated using the formula:hemoglobin(g/L)×albumin(g/L)×lymphocytes(/L)/platelets(/L),and was divided into three tertiles.Binary logistic regression analysis was employed to explore the association between HALP and cognitive outcomes.Results:The HALP scores were found to be significantly lower in the PSCI group compared to the non‑PSCI group(P<0.001).The HALP scores were divided into three categories:T1≤33.90,T233.90~53.75,and T3>53.75.In the binary logistic regression analysis,after controlling for confounding factors,the risk of PSCI was significantly higher in the T1 tertile compared to the T3 tertile(OR=9.38,95%CI=1.93~45.95,P=0.006).However,there was no significant increase in the risk of PSCI in the T2 tertile(OR=1.52,95%CI=0.58~4.02,P=0.393).Conclusion:The HALP score in the acute phase of AIS is associated with PSCI,and furthermore,the HALP score has diagnostic value for PSCI.

关 键 词：急性缺血性卒中 HALP评分 卒中后认知障碍 危险因素 

分 类 号：R743.3[医药卫生—神经病学与精神病学]