摘要
目的探讨C反应蛋白与血清白蛋白比值（C-reactive protein-to-albumin ratio, CAR）对急性缺血性卒中患者30 d生存状况的预测价值。
方法选取南方医科大学南方医院神经重症监护病房（Neurological Intensive Care Unit, NICU）2013年至2016年收治的急性缺血性卒中患者，根据30 d生存状况分为生存组和死亡组，对比分析两组患者的临床资料。采用多变量logistic回归分析确定30 d生存状况的独立危险因素，应用受试者工作特征曲线（receiver operating characteristic curve, ROC）分析变量的预测价值。
结果共纳入236例患者，死亡组64例（27.12%），生存组172例（72.88%）。生存组患者基线美国国立卫生研究院卒中量表评分、降钙素原、C反应蛋白、CAR以及发病至收住NICU时间均低于或短于死亡组，血清白蛋白水平高于死亡组，差异均有统计学显著性（P均〈0.05）。Pearson相关性分析显示，C反应蛋白（r＝0.647，P〈0.001）、CAR（r＝0.632，P〈0.001）以及发病至收住NCU时间（r＝0.596，P〈0.001）与急性缺血性卒中患者30 d生存状况密切相关。多变量logistic回归分析显示，CAR是急性缺血性卒中患者30 d死亡的独立危险因素（优势比1.895，95%可信区间1.573～2.282；P〈0.001）。ROC曲线分析显示，CAR的曲线下面积为0.873（95%可信区间0.815～0.931），最佳截断值为2.197，预测30 d死亡风险的敏感性为82.8%，特异性为87.8%。
结论CAR是急性缺血性卒中患者30 d死亡的独立危险因素，可用于急性缺血性卒中患者30 d生存评估。
ObjectiveTo investigate the predictive value of C-reactive protein/albumin ratio （CAR） for 30 d survival status in patients with acute ischemic stroke.
MethodsPatients with acute ischemic stroke admitted to the Neurological Intensive Care Unit （NICU）, Nanfang Hospital, Southern Medical University were selected from 2013 to 2016. They were divided into a survival group and a death group according to the 30 d survival status. The clinical data of both groups were compared and analyzed. Multivariate logistic regression analysis was used to determine the independent risk factors for 30 d survival status. The predictive value of the variables was analyzed using the receiver operating characteristic （ROC） curve.
ResultsA total of 236 patients were enrolled in the study, including 64 （27.12%） in the death group and 172 （72.88%） in the survival group. The baseline National Institutes of Health Stroke Scale score, procalcitonin, C-reactive protein, CAR, and onset to NICU time in patients of the survival group were significantly lower or shorter than those of the death group, and the serum albumin level of the survival group was higher than that of the death group （all P〈0.05）. Pearson＇s correlation analysis showed that C-reactive protein （r=0.647, P〈0.001）, CAR （r=0.632, P〈0.001）, and onset to NICU time （r=0.596, P〈0.001） were closely associated with the 30 d survival status in patients with acute ischemic stroke. Multivariate logistic regression analysis showed that CAR was an independent risk factor for 30 d mortality in patients with acute ischemic stroke （odds ratio 1.895, 95% confidence interval 1.573-2.282; P〈0.001）. ROC curve analysis showed that the area under the curve of CAR was 0.873 （95% confidence interval 0.815-0.931）, the optimal cut-off value was 2.197, the sensitivity of predicting 30 d death risk was 82.8%, and the specificity was 87.8%.
ConclusionCAR is an independent risk factor for 30 d death in patients with acute ischemic stroke and ca
出处
《国际脑血管病杂志》
2017年第12期1083-1088,共6页
International Journal of Cerebrovascular Diseases
基金
国家自然科学基金（81471339）
