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| 血清C反应蛋白与前白蛋白在高血压脑出血患者预后评估中的作用 |
| The role of serum c-reactive protein and prealbumin in prognosis evaluation of patients with hypertensive cerebral hemorrhage |
| 投稿时间：2021-05-12 修订日期：2022-01-14 |
| DOI： |
| 中文关键词: C反应蛋白 前白蛋白 比值 脑出血 预后 |
| 英文关键词: C-reactive protein prealbumin ratio prognosis cerebral hemorrhage |
| 基金项目: |
| 作者 | 单位 | 邮编 | | 乔元元 | 济宁医学院附属医院 | 272029 | | 张晓娟* | 济宁医学院附属医院 | | | 陈涛 | 济宁医学院附属医院 | | | 王瑶 | 济宁医学院附属医院 | | | 王标 | 济宁医学院附属医院 | | | 姜文 | 济宁医学院附属医院 | |
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| 中文摘要: |
| 目的 探讨血清C-反应蛋白与前白蛋白比值（CRP/PA）与成人脑出血患者预后的相关性。方法 采用回顾性分析方法，以2018年1月到2020年10月在山东省济宁医学院附属医院重症医学科治疗的脑出血患者为研究对像，共纳入154例，根据其预后是否出现重大残疾(mRS:3-6分)或死亡，将患者分为对照组(n=84)及重残组(n=70)，比较两组患者的性别、年龄、体重指数、血常规、CRP/PA、生化指标、凝血指标及合并内科疾病情况等一般资料。将患者P值<0.05的因素绘制受试者工作特征（ROC）曲线，分析CRP,CRP/PA对脑出血患者出现重大残疾的预测价值和最佳临界点。结果 两组患者性别、年龄、体重指数、血红蛋白、电解质、凝血指标及合并内科情况均无统计学差异。两组患者入院24小时内白细胞，血糖、C反应蛋白、前白蛋白、CRP/PA比较有统计学差异（P<0.05)。两组患者第7日的C反应蛋白、前白蛋白及CRP/PA比值比较亦有统计学差异（P<0.05）。ROC曲线分析结果显示，CRP/PA预测脑出血重残率的ROC曲线下面积为0.708〔95%CI（0.627，0.789）〕，预测临界值为0.212，预测临界值对应的灵敏度为59.5%，特异度为73.8%。7天后CRP预测高血压脑出血患者出现重大残疾或死亡的ROC曲线下面积0.716〔95%CI（0.636，0.797）〕，预测临界值为24.65mg/L，预测临界值对应的灵敏度为79.7%，特异度为55%。结论 脑出血患者7天后CRP和CRP/PA值可对脑出血病人的预后做出评估，若其水平持续升高提示预后不良。 |
| 英文摘要: |
| Objective To investigate the correlation between the ratio of serum C- reactive protein to prealbumin (CRP/PA) and the prognosis of cerebral hemorrhage in adults. Methods A retrospective analysis was used. A total of 154 patients who suffered from cerebral hemorrhage and received treatment in Department of Intensive Care, Affiliated Hospital of Jining Medical Uninersity, Shandong Province from January 2018 to October 2020 were included in the study. According to whether they had severe disability (MRS: 3–6 points) or died after treatment, they were divided into the control group (n=84) and the severely disabled group (n=70). The general data of gender, age, body mass index, routine blood test, CRP/PA, biochemical indicators, coagulation indicators and combined internal medicine diseases of the two groups were compared. The ROC curve was drawn based on the factor of P value < 0.05 in the patients. The predictive value and optimal critical point of CRP,CRP/PA for severe disability in patients with cerebral hemorrhage were analyzed. Results There were no significant differences in gender, age, body mass index, hemoglobin, electrolytes, coagulation indexes or the combined medical conditions between the two groups. There were significant differences in WBC, blood glucose, C-reactive protein, prealbumin, and CRP/PA within 24 hours of admission between the two groups (P<0.05). C-reactive protein, prealbumin and CRP/PA ratio on the 7th day between the two groups were also statistically different (P<0.05). The results of ROC curve analysis showed that the area under ROC curve of CRP/PA in the prediction of severe disability rate of cerebral hemorrhage was 0.708 [95% CI (0.627, 0.789)], the prediction threshold was 0.212, and the sensitivity and specificity corresponding to the prediction threshold were 59.5% and 73.8%, respectively. Seven days later, the area under the ROC curve of CRP in the prediction of severe disability or death in patients with hypertensive intracerebral hemorrhage was 0.716 [95% CI (0.636, 0.797)], the prediction threshold was 24.65mg/L, and the sensitivity and specificity corresponding to the prediction threshold were 79.7% and 55%, respectively. Conclusion CRP and CRP/PA values in patients with cerebral hemorrhage 7 days later can be used to assess the prognosis of patients with cerebral hemorrhage. If the level continues to increase, it indicates a poor prognosis. |
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