CAJ | 학술논문

目的：血清清蛋白作为一种神经保护剂其与急性缺血性脑卒中功能预后的关系尚无一致结论。文中旨在探讨营养状态良好的急性缺血性脑卒中患者血清清蛋白水平与短期功能预后的关系。方法收集2015年1月至2015年6月南京卒中登记系统中首次发病的急性缺血性脑卒中患者113例，收集人口学参数、人体测量参数、血管危险因素等相关临床及实验室检查等基线资料。采用美国国立卫生院卒中评估量表（ National Institutes of Health Stroke Scale ， NIHSS）对入院时的神经功能缺损严重程度进行评定，及出院时用改良Rankin评分（modified Rankin Scale， mRS）对短期功能预后进行评定，根据出院时mRS将患者分为预后良好组（ mRS＜3分）和预后不良组（ mRS≥3分），最后采用多因素Logistic回归分析评估功能预后的独立预测因素。结果预后良好组52例（46．0％），预后不良组61例（54．0％）。与预后不良组患者比较，功能预后良好组患者BMI较高，而LDL-C、WBC较低，且入院时的NIHSS较低（P＜0．05）。多因素Logistic回归分析显示：血清清蛋白较低、入院NIHSS、小动脉闭塞型是短期功能预后不良的独立预测因素；随着血清清蛋白水平的增加，患者功能预后不良的趋势降低（OR＝0．684，95％CI：0．490～0．956）；NIHSS增高患者功能预后不良的趋势增加（OR＝3．490，95％CI：1．966～6．194）；小动脉闭塞也是患者功能预后不良危险因素（OR＝11．443，95％CI：1．160～112．857）。结论在营养状态良好的急性缺血性脑卒中患者中，血清清蛋白水平较低仍然是短期功能预后不良的独立预测因素。
목적：혈청청단백작위일충신경보호제기여급성결혈성뇌졸중공능예후적관계상무일치결론。문중지재탐토영양상태량호적급성결혈성뇌졸중환자혈청청단백수평여단기공능예후적관계。방법수집2015년1월지2015년6월남경졸중등기계통중수차발병적급성결혈성뇌졸중환자113례，수집인구학삼수、인체측량삼수、혈관위험인소등상관림상급실험실검사등기선자료。채용미국국립위생원졸중평고량표（ National Institutes of Health Stroke Scale ， NIHSS）대입원시적신경공능결손엄중정도진행평정，급출원시용개량Rankin평분（modified Rankin Scale， mRS）대단기공능예후진행평정，근거출원시mRS장환자분위예후량호조（ mRS＜3분）화예후불량조（ mRS≥3분），최후채용다인소Logistic회귀분석평고공능예후적독립예측인소。결과예후량호조52례（46．0％），예후불량조61례（54．0％）。여예후불량조환자비교，공능예후량호조환자BMI교고，이LDL-C、WBC교저，차입원시적NIHSS교저（P＜0．05）。다인소Logistic회귀분석현시：혈청청단백교저、입원NIHSS、소동맥폐새형시단기공능예후불량적독립예측인소；수착혈청청단백수평적증가，환자공능예후불량적추세강저（OR＝0．684，95％CI：0．490～0．956）；NIHSS증고환자공능예후불량적추세증가（OR＝3．490，95％CI：1．966～6．194）；소동맥폐새야시환자공능예후불량위험인소（OR＝11．443，95％CI：1．160～112．857）。결론재영양상태량호적급성결혈성뇌졸중환자중，혈청청단백수평교저잉연시단기공능예후불량적독립예측인소。
Objective No consensus has yet been achieved on the relationship of serum albumin with the functional out-come of acute ischemic stroke.The aim of our study was to determine whether the serum albumin level was associated with the short-term functional outcome of acute ischemic stroke in well-nourished patients. Methods Totally, 113 patients with first-ever acute ischemic stroke were recruited from Nanjing Stroke Registration Program between January and June 2015.Baseline data including de-mographic and body parameters, vascular risk factors, and laboratory results were collected.The NIH Stroke Scale ( NIHSS) was used to evaluate the severity of neurological deficits and the modified Rankin Scale ( mRS ) employed to assess the short-term functional outcome.According to the mRS at discharge, the patients were divided into a good outcome group ( mRS<3 ) and a poor out-come group ( mRS≥3 ) .The independent predictors of the short-term functional outcome were evaluated by multivariate logistic regression analysis. Results Of the 113 acute ischemic stroke patients included, 52 (46.0%) were in the good outcome group, and 61 (54.0%) in the poor outcome group.Those in the former group had a significantly higher BMI, lower serum LDL-C, lower WBC count, and lower NIHSS at admission than those in the latter .Multivariate logistic regression analysis showed that low serum albumin, NIHSS at admission, and arteriole occlusion were independent predictors of the poor short-term functional outcome ( OR=0.684, 95% CI:0.490-0.956, P=0.026). Conclusion Low serum albumin is an independent predictor of poor short-term functional outcome in acute ischemic stroke patients in well-nourished status.