血清清蛋白水平与缺血性脑卒中患者出院后死亡风险的相关性
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国家自然科学基金(81872686)。


Study on relationship between serum albumin level and risk of death in patients with ischemic stroke after discharge from hospitals
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    摘要:

    目的?观察血清清蛋白(Alb)与缺血性脑卒中(IS)患者出院后死亡风险的相关性。方法?连续性纳入2009 年4 月至2017 年12月于江苏大学附属宜兴医院首次诊断为IS的患者共2 207例,收集一般人口学资料、生化指标检测结果,于2018年12月至2019年4月集中随访,排除失访及Alb信息缺失者,最终共1 976例纳入研究分析。参照限制性立方条样曲线选取合适截断值,将Alb>41 g/L共991例患者作为高Alb组;将Alb≤41 g/L共985例患者作为低Alb组,采用COX比例风险回归模型分析Alb表达水平高低对IS患者出院后发生死亡的相对危险度(HR)。结果?在1 976例随访IS患者中(中位数随访时间为4.72年),出院6个月后死亡102例。经多因素COX回归分析,校正性别、年龄、吸烟、饮酒、血脂、高血压史、糖尿病史后,低Alb组相对于高Alb组死亡风险增加1.618倍(HR=1.618,95%CI:1.060~2.469)。进一步分层分析结果显示,年龄超过65岁、男性、有高血压史的对象中,低Alb组相对于高Alb组死亡风险显著增加,且在TOAST 分型中,低Alb 组相对于高Alb 组在大动脉粥样硬化型(LAA)时死亡风险增加。结论?Alb水平低的IS患者出院后死亡风险增加。

    Abstract:

    Objective?To study the correlation between serum albumin(Alb)level and death risk of ischemic stroke(IS)patients after discharge.Methods?A total of 2 207 patients who were first diagnosed as IS and discharged from Yixing Hospital affiliated to Jiangsu University from April 2009 to December 2017 were continuously included.The general demographic data and results of biochemical tests of the respondents were collected,and centralized follow-up was conducted from December 2018 to April 2019.Those who lost follow-up and Alb information were excluded.Finally,a total of 1 976 patients were included for analysis in the study.According to the restricted cubic spline curve,an appropriate cut-off value was selected to group the patients.The high Alb group consisted of 991 patients with Alb>41 g/L,and low Alb group consisted of 985 patients with Alb≤41 g/L .COX proportional hazard regression model was used to analyze the hazard ratio(HR)of Alb expression level to the death of IS patients after discharge.Results?Among the 1 976 subjects with 4.72 years of median follow-up time,102 cases died of ischemic stroke during 6 months after discharge.Following multivariate COX regression analysis to correct gender,age,smoking,drinking,blood lipid,history of hypertension and diabetes,the low Alb group had a 1.618-fold increased risk of death compared with the high Alb group(HR=1.618,95%CI:1.060-2.469).The results of further stratified analysis showed that among the male subjects over 65 years of age with history of hypertension,the risk of death in the low Alb group was significantly higher than that in the high Alb group.In TOAST classification,the risk of death in low Alb group was increased compared to high Alb group with the type of large-artery atherosclerosis(LAA)showing statistically significant difference.Conclusion?Low level of Alb may increase the death risk of IS patients after discharge.

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吴恺迪,尹霄,任占云,赵彦平,董佳怡,沈冲,马铁梁,陈如华.血清清蛋白水平与缺血性脑卒中患者出院后死亡风险的相关性[J].临床检验杂志,2021,39(7):500-503

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  • 收稿日期:2021-03-23
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  • 在线发布日期: 2021-09-09
  • 出版日期: 2021-07-28
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