急性缺血性卒中血管内治疗术后血清前白蛋白水平与预后的相关性研究

doi:10.3969/j.issn.1673-5765.2022.07.014

摘要/Abstract

摘要：

目的探讨急性缺血性卒中血管内治疗术后低血清前白蛋白血症的发生情况及其与预后的相关性。

方法本研究前瞻性连续收集2017年7月-2020年10月来自全国18家分中心，符合条件的急性缺血性卒中血管内治疗患者的数据。依据患者血管内治疗术后24 h内的血清前白蛋白水平分为低前白蛋白组和正常前白蛋白组，低前白蛋白定义为血管内治疗术后24 h内患者一次或多次血清前白蛋白水平<170 mg/L。采用logistic回归分析低前白蛋白水平对发病90 d内的神经功能预后（mRS 0～2分为预后良好）、发病90 d内死亡、早期神经功能恶化以及任何形式的颅内出血、症状性颅内出血的影响。

结果研究纳入1254例患者，其中低前白蛋白组289例（23.05%），正常前白蛋白组965例（76.95%）。logistic回归分析结果显示，低前白蛋白水平是发病90 d良好神经功能预后（aOR 0.48，95%CI 0.35～0.66，P<0.01）、发病90 d内死亡（aOR 1.84，95%CI 1.29～2.64，P<0.01）的独立影响因素，但对早期神经功能恶化、任何形式的颅内出血、症状性颅内出血无明显影响（P>0.05）。

结论对于急性缺血性卒中血管内治疗术后患者，低前白蛋白血症发生与发病90 d不良预后发生有显著相关性。

文章导读： 急性缺血性卒中EVT术后低前白蛋白水平与90 d不良预后明显相关，且与术后多系统并发症增加相关。

关键词: 缺血性卒中; 血管内治疗; 前白蛋白

Abstract:

Objective To explore the occurrence of serum hypoprealbuminemia and its correlation with prognosis after endovascular treatment of acute ischemic stroke.

Methods This study prospectively collected the data of patients who underwent endovascular treatment for acute ischemic stroke in 18 sub-centers in China from July 2017 to October 2020. According to serum prealbumin level within 24 hours after surgery, the patients were divided into low prealbumin group and normal prealbumin group. Low prealbumin was defined as the serum prealbumin level is lower than 170 mg/L within 24 hours after endovascular therapy in one or more detections. Good prognosis was defined as a mRS score of 0-2. The logistic regression analysis was used to evaluate the correlation of low prealbumin level with short-term prognosis and long-term (90 days) prognosis. The short-term prognosis included early neurological deterioration, any intracranial hemorrhage within 72 hours after surgery. The mRS was used to evaluate 90-day prognosis.

Results A total of 1254 patients was included in this study, including 289 patients (23.05%) in low prealbumin group and 965 (76.95%) in normal prealbumin group. Logistic regression analysis showed that the low prealbumin level was an independent influencing factor for 90-day good prognosis (aOR 0.48, 95%CI 0.35-0.66, P<0.01), and 90-day death (aOR 1.84, 95%CI 1.29-2.64, P<0.01), but had no effect on early neurological deterioration and any intracranial hemorrhage (P>0.05).

Conclusions For acute ischemic stroke patients after endovascular therapy, the occurrence of hypoprealbuminemia was correlated with 90-day poor prognosis.

Key words: Ischemic stroke; Endovascular treatment; Prealbumin

崔晓玉, 聂曦明, 刘丽萍. 急性缺血性卒中血管内治疗术后血清前白蛋白水平与预后的相关性研究[J]. 中国卒中杂志, 2022, 17(07): 758-763.

CUI Xiaoyu, NIE Ximing, LIU Liping. Correlation of Hypoprealbuminemia and Outcome after Endovascular Treatment for Acute Ischemic Stroke[J]. Chinese Journal of Stroke, 2022, 17(07): 758-763.

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