Zhongguo cuzhong zazhi (Dec 2024)

系统性免疫炎症指数、C反应蛋白/白蛋白比值对急性缺血性卒中患者溶栓后短期预后的评估价值 Evaluation Value of Systemic Immune-Inflammation Index and C-Reactive Protein/Albumin Ratio in Short-Term Prognosis of Patients with Acute Ischemic Stroke after Thrombolytic Therapy

  • 刘晓梅，苟重季，付丽(LIU Xiaomei, GOU Zhongji, FU Li )

DOI
https://doi.org/10.3969/j.issn.1673-5765.2024.12.012
Journal volume & issue
Vol. 19, no. 12
pp. 1448 – 1453

Abstract

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目的 探讨系统性免疫炎症指数（systemic immune-inflammation index，SII）、CRP/白蛋白（albumin，ALB）对接受rt-PA溶栓治疗的急性缺血性卒中（acute ischemic stroke，AIS）患者短期预后的预测作用。 方法 回顾性分析彭州市人民医院2022年1—12月收治的接受rt-PA溶栓治疗的AIS患者临床病例资料。采用mRS评估患者发病后30 d预后情况，mRS评分≤2分为预后良好，mRS评分>3分为预后不良。采集入院时外周血检验结果计算SII和CRP/ALB。单因素和logistic多因素分析AIS患者预后的影响因素。采用ROC曲线分析SII、CRP/ALB对AIS患者预后的预测作用。 结果 本研究共纳入134例AIS患者，其中预后不良者29例（21.64%）。单因素分析发现，预后不良患者入院时NIHSS评分、血小板计数、D-二聚体、凝血酶原时间、TC、CRP、SII、CRP/ALB高于预后良好患者，差异有统计学意义（P3 points was considered a poor prognosis. SII and CRP/ALB were calculated from peripheral blood test results at admission. The factors influencing prognosis of AIS patients were analyzed by univariate and logistic multivariate analysis. The predictive effects of SII and CRP/ALB on the prognosis of AIS patients were analyzed using the ROC curve. Results A total of 134 AIS patients were included in this study, of which 29 patients (21.64%) had poor prognosis. Univariate analysis showed that NIHSS score, platelet count, D-dimer, prothrombin time, TC, CRP, SII, and CRP/ALB in patients with poor prognosis were higher than those with good prognosis, and the differences were statistically significant (P<0.05). The lymphocyte count and ALB in patients with poor prognosis were lower than those with good prognosis, and the differences were statistically significant (P<0.05). Logistic multivariate analysis showed that NIHSS score (OR 19.028, 95%CI 2.785-27.348, P<0.001), TC (OR 6.979, 95%CI 1.851-12.191, P=0.009), CRP (OR 7.830, 95%CI 2.559-14.252, P=0.002), ALB (OR 0.192, 95%CI 0.101-0.662, P＜0.001), SII (OR 9.244, 95%CI 2.571-19.379, P<0.001), and CRP/ALB (OR 11.100, 95%CI 3.570-22.451, P<0.001) were independent influencing factors of poor prognosis. ROC curve analysis showed that SII and CRP/ALB had predictive value for poor prognosis, with AUC of 0.648 (95%CI 0.529-0.767, P=0.015) and 0.749 (95%CI 0.664-0.883, P<0.001), sensitivity of 0.448 and 0.931, and specificity of 0.876 and 0.562, respectively. Conclusions SII and CRP/ALB are independent influencing factors for poor prognosis of patients, and combined assessment of SII and CRP/ALB is helpful for early identification of high-risk AIS patients.

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