| 乔元元,张晓娟,陈涛,王瑶,王标,姜文.血清C反应蛋白及其与前白蛋白比值对高血压脑出血患者预后的评估[J].济宁医学院学报,2022,45(2):98-101 |
| 血清C反应蛋白及其与前白蛋白比值对高血压脑出血患者预后的评估 |
| Serum C-reactive protein, the ratio of serum C-reative protein to prealbumin and prognosis of patients with hypertensive intracerebral hemorrhage |
| 投稿时间：2021-03-09 |
| DOI：10.3969/j.issn.1000-9760.2022.02.006 |
| 中文关键词: C反应蛋白;前白蛋白;脑出血;预后 |
| 英文关键词: C-reactive protein;Prealbumin;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 | 272029 | | 陈涛 | 济宁医学院附属医院 | 272029 | | 王瑶 | 济宁医学院附属医院 | 272029 | | 王标 | 济宁医学院附属医院 | 272029 | | 姜文 | 济宁医学院附属医院 | 272029 |
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| 中文摘要: |
| 目的 探讨血清C-反应蛋白及其与前白蛋白比值(CRP/PA)对高血压脑出血患者预后的评估作用。 方法 采用回顾性分析方法，以2018年1月到2020年10月在济宁医学院附属医院重症医学科治疗的高血压脑出血患者为研究对象，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=80)及重残组(n=74)，比较两组患者的性别、年龄、BMI、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。绘制受试者工作特征(ROC)曲线，分析CRP、CRP/PA对高血压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、体重指数等一般情况均无统计学差异。两组患者入院24h内白细胞，血糖、CRP、前白蛋白(PA)、CRP/PA比较有统计学差异(P < 0.05)。两组患者第7天的CRP、PA及CRP/PA比值比较亦有统计学差异(P < 0.05)。ROC曲线分析显示，CRP/PA预测高血压脑出血患者不良临床结局ROC曲线下面积为0.708[95%CI(0.627，0.789)]，预测临界值为0.212，其灵敏度为59.5%，特异度为73.8%。7d CRP预测高血压脑出血患者不良临床结局ROC曲线下面积0.716[95%CI(0.636，0.797)]，预测临界值为24.65mg/L，其灵敏度为79.7%，特异度为55%。 结论 高血压脑出血患者7d后CRP和CRP/PA值可评估脑出血患者的预后，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 patients. Methods A retrospective analysis was used.A total of 154 patients with cerebral hemorrhage who were received for treatment in Department of Intensive Care, Affiliated Hospital of Jining Medical Uninersity, Shandong Province from Jan.2018 to Oct.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 cerebral 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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