白蛋白/纤维蛋白原比值对急性缺血性脑卒中患者静脉溶栓后预后不良的预测价值  

Predictive Value of Albumin/Fibrinogen Ratio for Poor Prognosis in Patients with Acute Ischemic Stroke after Intravenous Thrombolysis

作　　者：马爽 孟新颜 辛在娥[1] 吕存玲 杨承志[1] 陈国芳[1] MA Shuang;MENG Xinyan;XIN Zaie;LYU Cunling;YANG Chengzhi;CHEN Guofang(Department of Neurology,Xuzhou Central Hospital,Xuzhou 221009,China)

机构地区：[1]江苏省徐州市中心医院神经内科,221009

出　　处：《实用心脑肺血管病杂志》2025年第5期46-51,共6页Practical Journal of Cardiac Cerebral Pneumal and Vascular Disease

基　　金：江苏省干部保健科研课题(BJ20007);江苏省新药研究与临床药学重点实验室开放研究课题(XZSYSKF2020022);徐州市医学领军人才培养项目(XWRCHT20210037)。

摘　　要：目的探讨白蛋白/纤维蛋白原比值对急性缺血性脑卒中(AIS)患者静脉溶栓后预后不良的预测价值。方法连续收集2023年9月—2024年6月在徐州市中心医院进行静脉溶栓治疗的AIS患者。收集所有研究对象的临床资料,根据改良Rankin量表(mRS)评分将患者分为预后不良和预后良好。采用多因素Logistic回归分析探讨AIS患者静脉溶栓后预后的影响因素;绘制ROC曲线分析白蛋白/纤维蛋白原比值对AIS患者静脉溶栓后预后不良的预测价值。结果共纳入306例AIS患者,其中预后良好246例(80.39%),预后不良60例(19.61%)。预后良好与预后不良患者年龄、有心房颤动史者占比、TOAST分型、NIHSS评分、血糖、WBC、中性粒细胞计数、淋巴细胞计数、白蛋白、纤维蛋白原、中性粒细胞与淋巴细胞比值(NLR)、白蛋白/纤维蛋白原比值比较,差异有统计学意义(P<0.05)。多因素Logistic回归分析结果显示,心房颤动史[OR=4.974,95%CI(1.536~16.110)]、NIHSS评分[OR=1.378,95%CI(1.235~1.538)]、血糖[OR=1.285,95%CI(1.104~1.495)]、NLR[OR=1.182,95%CI(1.054~1.325)]、白蛋白/纤维蛋白原比值[OR=0.835,95%CI(0.748~0.933)]是AIS患者静脉溶栓后预后的独立影响因素(P<0.05)。ROC曲线分析结果显示,白蛋白/纤维蛋白原比值预测AIS患者静脉溶栓后预后不良的AUC为0.758[95%CI(0.685~0.832)],最佳截断值为11.75,Youden指数为0.466,灵敏度为60.0%,特异度为86.6%。结论白蛋白/纤维蛋白原比值是AIS患者静脉溶栓后预后的独立影响因素,且白蛋白/纤维蛋白原比值对AIS患者静脉溶栓后预后不良具有一定的预测价值。Objective To investigate the predictive value of albumin/fibrinogen ratio for poor prognosis in patients with acute ischemic stroke(AIS)after intravenous thrombolysis.Methods Patients with AIS received intravenous thrombolysis treatment in Xuzhou Central Hospital from September 2023 to June 2024 were continuously collected.The clinical data of the patients were collected.The patients were divided into poor prognosis and good prognosis according to the modified Rankin Scale(mRS)score.Multivariate Logistic regression analysis was used to explore the influencing factors of prognosis in patients with AIS after intravenous thrombolysis.ROC curve was drawn to explore the predictive value of albumin/fibrinogen ratio for poor prognosis in patients with AIS after intravenous thrombolysis.Results A total of 306 patients with AIS were included,of which 246(80.39%)had a good prognosis and 60(19.61%)had a poor prognosis.There were significant differences in age,proportion of patients with atrial fibrillation history,TOAST classification,NIHSS score,blood glucose,WBC,neutrophil count,lymphocyte count,albumin,fibrinogen,neutrophil to lymphocyte ratio(NLR),and albumin/fibrinogen ratio between patients with good prognosis and patients with poor prognosis(P<0.05).Multivariate Logistic regression analysis showed that atrial fibrillation history[OR=4.974,95%CI(1.536-16.110)],NIHSS score[OR=1.378,95%CI(1.235-1.538)],blood glucose[OR=1.285,95%CI(1.104-1.495)],NLR[OR=1.182,95%CI(1.054-1.325)],albumin/fibrinogen ratio[OR=0.835,95%CI(0.748-0.933)]were independent influencing factors for prognosis in patients with AIS after intravenous thrombolysis(P<0.05).ROC curve analysis results showed that the AUC of albumin/fibrinogen ratio for predicting poor prognosis in patients with AIS after intravenous thrombolysis was 0.758[95%CI(0.685-0.832)],the optimal cutoff value was 11.75,Youden index was 0.466,sensitivity was 60.0%,and specificity was 86.6%.Conclusion Albumin/fibrinogen ratio is independent influencing factor for prognosis in patients

关 键 词：卒中 白蛋白/纤维蛋白原比值 静脉溶栓 预后 

分 类 号：R743[医药卫生—神经病学与精神病学]