入院血清白蛋白水平对急性脑梗死患者出院转归的影响

摘要

目的 探讨血清白蛋白(ALB)水平对急性脑梗死(ACI)患者出院转归的影响.方法 纳入2011年6月1日-2014年5月31日阜新市中心医院3 151例ACI患者,收集人口统计学、生活方式、入院时ALB水平等实验室检查结果.根据出院脑卒中量表评分分为转归良好组(0≤MRS≤2),转归不良组(3≤MRS≤6).把入院时ALB水平按照四分位数分为4组,采用非条件Logistic回归分析入院时ALB水平与ACI患者出院不良转归的关联. 结果 转归不良组的入院ALB水平低于转归良好组(P<0.05);经多因素调整后,以ALB第1分位数为参比,第2、3和4分位数降低了ACI患者出院转归不良的发生风险, OR(95%CI)分别为0.814(0.627~1.058)、0.626(0.472~0.831)和0.556(0.413~0.749),且随着ALB水平的增加ACI患者发生不良转归的风险降低(趋势性检验P<0.0001).结论 ACI患者入院时高水平的ALB能降低出院不良转归的发生风险,并且为独立、连续的保护因素.%Objective To investigate the effect of serum albumin(ALB) at admission on the outcome of discharged patients with acute cerebral infarction(ACI). Method We collected data on population statistics, lifestyle, ALB level of 3151 patients with ACI from June 2011 to May 2014 in Fuxin central hospital. According to modified Rankin scale (MRS), good outcome was defined as 0 ≤ MRS ≤ 2 while poor outcome was defined as 3≤MRS≤6. Serum ALB was divided into four groups according to the quartile. Multiple Logistic regression analysis was used to assess the independent association between serum ALB and bad outcome. Results The level of serum ALB in the group of poor outcome were lower than that of good (P<0.05). The risks of poor outcome with serum ALB in the second, third and the forth quartile were lower than that in the first quartile, OR and 95%CI were 0.814(0.627-1.058),0.626(0.472-0.831) and 0.556(0.413-0.749) respectively, after adjusting for confounding factors. As serum ALB was higher, the risk of poor outcome was lower (trend P<0.0001). Conclusion The study indicated that high level of serum ALB may be an independently continuously protective factor and lower the risk of bad outcome of discharged patients with ACI.