C反应蛋白/白蛋白比值与老年脑梗死合并肺部感染的关系及对患者预后的预测价值  

The Relationship between C-reactive Protein/Albumin Ratio and Cerebral Infarction Complicated with Pulmonary Infection in Elderly Patients and Its Prognostic Value

作　　者：杨小钧 陈硕[2] 徐旭慧 周庆坤 韩莉 王加林 刘艳[2] YANG Xiaojun;CHEN Shuo;XU Xuhui;ZHOU Qingkun;HAN Li;WANG Jialin;LIU Yan(Department of Geriatrics,Nanjing Tongren Hospital,Affiliated Hospital of Southeast University Medical School,Nanjing,Jiangsu 211100,China;Department of Neurology,Nanjing Tongren Hospital,Affiliated Hospital of Southeast University Medical School,Nanjing,Jiangsu 211100,China)

机构地区：[1]东南大学医学院附属医院南京同仁医院老年病科,江苏南京211100 [2]东南大学医学院附属医院南京同仁医院神经内科,江苏南京211100

出　　处：《转化医学杂志》2025年第3期71-76,共6页Translational Medicine Journal

摘　　要：目的分析C反应蛋白/白蛋白比值(CRP/ALB)与老年脑梗死合并肺部感染的关系及对患者预后的预测价值。方法回顾性选取2021年1月至2023年12月东南大学医学院附属医院南京同仁医院老年病科和神经内科收治的380例老年脑梗死患者为研究对象,根据住院期间是否发生肺部感染将患者分为肺部感染组(122例)和肺部未感染组(258例)。治疗后随访6个月,根据预后将老年脑梗死合并肺部感染患者分为预后不良组(30例)和预后良好组(92例)。所有受试者入院后均检测血清C反应蛋白(CRP)、白蛋白(ALB)水平,并计算CRP/ALB。采用受试者工作特性曲线(ROC)分析CRP/ALB对老年患者预后的评估价值,采用多因素Logistics回归分析探讨老年患者预后的危险因素。结果肺部感染组患者美国国立卫生研究院卒中量表(NIHSS)评分及血清CRP、CRP/ALB均高于肺部未感染组,ALB水平低于肺部未感染组,差异有统计学意义(P<0.05)。预后不良组患者NIHSS评分及血清CRP、CRP/ALB均高于预后良好组,ALB水平低于预后良好组,差异有统计学意义(P<0.05)。血清CRP、ALB预测老年脑梗死合并肺部感染患者预后的曲线下面积分别为0.804(95%CI:0.754~0.854)、0.851(95%CI:0.801~0.901),CRP/ALB预测老年脑梗死合并肺部感染患者预后的曲线下面积为0.905(95%CI:0.855~0.955)。多因素Logistics回归分析显示,CRP>30.33 mg/L(OR=3.047,95%CI:1.732~5.357)、ALB≤28.96 g/L(OR=2.776,95%CI:1.687~4.567)、CRP/ALB比值>1.28(OR=4.225,95%CI:2.078~8.589)均为老年脑梗死合并肺部感染患者预后的危险因素(P<0.05)。结论CRP/ALB在老年脑梗死合并肺部感染患者中异常升高,且与预后密切有关,有望作为评估患者预后的有效生物指标。Objective To analyze the relationship between C-reactive protein/albumin ratio(CRP/ALB)and pulmonary infection in elderly patients with cerebral infarction and its prognostic value.Methods A retrospective analysis was conducted on 380 elderly patients with cerebral infarction admitted to our hospital from January 2021 to December 2023,and the patients were divided into lung infection group(n=122)and non-infection group(n=258)based on hospital-acquired infection status.The patients with cerebral infarction combined with pulmonary infection were divided into poor prognosis group(n=30)and good prognosis group(n=92)according to the prognosis at 6 months after treatment.Serum C-reactive protein(CRP)and albumin(ALB)levels were detected in all subjects after admission,and CRP/ALB ratio was calculated.The value of CRP/ALB ratio in the prognosis of elderly patients with cerebral infarction combined with pulmonary infection was analyzed by receiver operating characteristic(ROC)curve.Meanwhile,the risk factors of prognosis in elderly patients were explored by multi-factor logistics regression analysis.Results The National Institutes of Health Stroke Scale(NIHSS)score,serum CRP and CRP/ALB ratio in pulmonary infection group were higher than those in non-infection group,and the ALB level was lower than that in non-infection group(P<0.05).The NIHSS score,serum CRP and CRP/ALB ratio in the poor prognosis group were higher than those in the good prognosis group,and the ALB level was lower than that in the good prognosis group(P<0.05).ROC curve results showed that the AUC of serum CRP and ALB in predicting the prognosis of elderly patients with cerebral infarction combined with pulmonary infection were 0.804(95%CI:0.754-0.854)and 0.851(95%CI:0.801-0.901),respectively.CRP/ALB ratio predicted the prognosis of elderly patients with cerebral infarction combined with pulmonary infection,and the AUC was 0.905(95%CI:0.855-0.955).Multivariate regression analysis showed that CRP>30.33 mg/L(OR=3.047,95%CI:1.732-5.357),ALB≤28.96 g/L(OR=2.

关 键 词：脑梗死 肺部感染 老年人 C反应蛋白/白蛋白比值 预后 

分 类 号：R743.33[医药卫生—神经病学与精神病学]