天津医药

天津医药 ›› 2020, Vol. 48 ›› Issue (4): 298-301.doi: 10.11958/20192412

• 临床研究 • 上一篇    下一篇

高敏C反应蛋白/白蛋白比值与复发性脑梗死的关系 #br#

金霞霞，徐玖飞，王静，沈波△
  

  1. 温州医科大学附属台州医院检验科（邮编317000）
  • 收稿日期:2019-08-13 修回日期:2019-10-20 出版日期:2020-04-15 发布日期:2020-06-23
  • 通讯作者: 沈波 E-mail:1282437689@qq.com
  • 作者简介:金霞霞（1987），女，本科，主管技师，主要从事临床检验工作

The relationship between high-sensitivity C-reactive protein/albumin ratio and#br# recurrent cerebral infarction #br#

JIN Xia-xia, XU Jiu-fei, WANG Jing, SHEN Bo△ #br#   

  1. Department of Laboratory Diagnosis, Taizhou Hospital Affiliated to Wenzhou Medical University, Linhai 317000, China
  • Received:2019-08-13 Revised:2019-10-20 Published:2020-04-15 Online:2020-06-23
  • Contact: SHEN Bo E-mail:1282437689@qq.com

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摘要： 目的 探讨高敏 C反应蛋白/白蛋白（hs-CRP/Alb）比值与脑梗死复发的关系。方法 选取 2018年 1月—
12月在浙江省台州医院神经内科住院的 69例复发性脑梗死（RCI）患者作为病例组及 107例首次发作的脑梗死患者
（FCI）作对照组，记录 2组患者的临床资料，并检测其血常规、血沉（ESR）、糖化血红蛋白（HbA1c）、高敏 C反应蛋白
（hs-CRP）、谷丙转氨酶（ALT）、谷草转氨酶（AST）、低密度脂蛋白胆固醇（LDL-C）、血糖（Glu）、同型半胱氨酸（Hcy）、白蛋白（Alb）、总胆红素（TBil）、直接胆红素（DBil）、前白蛋白（PA）、并计算 hs-CRP/Alb比值。应用 Logistic回归分析脑梗死复发的影响因素，采用ROC曲线评价hs-CRP/Alb比值预测脑梗死复发的价值。结果 单因素分析时，RCI组
糖尿病患病率、住院时间、住院费用、HbA1c、hs-CRP、TBil、DBil及 hs-CRP/Alb比值均明显高于 FCI组，而 Alb、PA低
于 FCI 组（P＜0.05）。2 组间性别、高血压、WBC、Glu、ALT、AST 及 LDL-C 差异无统计学意义（P＞0.05）。多因素
Logistic回归分析结果显示，并发DM（OR=3.834，95%CI：1.176～12.503，P=0.026）及较高hs-CRP/Alb比值（OR=8.513，95%CI：1.139～63.638，P=0.037）为脑梗死复发的独立危险因素。ROC曲线显示入院 hs-CRP/Alb比值预测脑梗死复发的曲线下面积为0.635（95%CI：0.551～0.719，P=0.033），当Cut off值为0.07时诊断价值最高，敏感度为59.4%，特异度为61.7%。结论 hs-CRP/Alb比值为脑梗死复发的独立危险因素，入院hs-CRP/Alb比值对脑梗死复发的预测有辅助价值。

关键词: 脑梗死, 复发, 预后, 危险因素, ROC曲线, 高敏C反应蛋白/白蛋白比值

Abstract: Objective To investigate the relationship between high-sensitivity C-reactive protein to albumin (hs-CRP/
Alb) ratio and recurrence cerebral infarction (RCI). Methods A total of 69 RCI patients hospitalized in Taizhou hospital
affiliated to Wenzhou medical university from January 2018 to December 2018 were selected as case group, and 107 first
cerebral infarction (FCI) patients were selected as control group. The clinical data were recorded. The levels of blood routine examination, erythrocyte sedimentation rate (ESR), glycosylated hemoglobin A1c (HbA1c), hs-CRP, alanine transaminase (ALT), aspartate transaminase (AST), low density lipoprotein cholesterol (LDL-C), glucose (Glu), homocysteine (Hcy), Alb,
total bilirubin (TBil), direct bilirubin (DBil) and prealbumin (PA) were detected, and hs-CRP/Alb were calculated.
Independent risk factors of cerebral infarction recurrence were analyzed by logistic regression, and the value of hs-CRP to
albumin ratio in predicting cerebral infarction recurrence was evaluated by ROC curve. Results In the univariate analysis,
the prevalence of diabetes, average hospital stay, average hospitalization cost, HbA1c, hs-CRP, TBil, DBil and hs-CRP/Alb
ratio were significantly higher in the RCI group than those in the FCI group, while Alb and PA were lower than FCI group
(P＜0.05). There were no significant differences in gender, hypertension, WBC, Glu, ALT, AST and LDL-C between the two
groups (P＞0.05). Multivariate Logistic regression analysis showed that DM (OR=3.834, 95%CI: 1.176-12.503, P=0.026）
and hs-CRP/Alb ratio (OR=8.513, 95%CI: 1.139-63.638，P=0.037) were independent risk factors for RCI. The ROC curve
showed that the area under the curve of hs-CRP/Alb ratio predicting RCI was 0.635 (95%CI: 0.551-0.719, P=0.033). When
the cut off value was 0.07, the sensitivity and specificity were 59.4% and 61.7% respectively. Conclusion The hs-CRP/
Alb ratio is an independent risk factor for cerebral infarction recurrence, and the hs-CRP/Alb ratio at the time of admission
is helpful for predicting the recurrence of cerebral infarction.

Key words: brain infarction, recurrence, prognosis, risk factors, ROC curve, hs-CRP/Alb ratio

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