Key Laboratory of Neurogenetics and Channelopathies of Guangdong Province and The Ministry of Education of China, Institute of Neuroscience and The Second Affiliated Hospital of GuangZhou Medical University, 250# Changgang East Road, 510260 GuangZhou, Guangdong Province, China.
Clin Exp Med. 2011 Mar;11(1):49-54. doi: 10.1007/s10238-010-0103-8. Epub 2010 Jun 10.
Low serum protein and albumin are considered to significantly associate with malnutrition, impaired functional status, poor outcome, and mortality. We hypothesized that serum prealbumin (transthyretin, PA) was a reliable and robust survival marker in young cerebral infarction patients and attempted to test the foregoing hypothesis. We analyzed the relationship between serum PA and stroke severity as determined by the modified Rankin Scale at discharge in 585 young cerebral infarction patients. By multivariate logistic regression modeling, we determined the influence of prealbumin on stroke severity, and the analyses were adjusted for the effects of potential confounders. Patients with a severe stroke had significantly more often prealbumin on admission in the lowest quintile (P = 0.031). Those cardiogenic cerebral infarction patients had significantly lower serum prealbumin concentrations and higher mRS scores. A logistic regression adjusted for confounders confirmed the following independent (odds ratio, 95% CI) good outcome predictors: uric acid (-0.002, 0.996-1.000) and prealbumin (-0.003, 0.995-1.000). Prealbumin is an independent predictor of the good clinical outcome of young cerebral infarction patients. The serum prealbumin may be a useful prognostic indicator for judging the prognosis of cerebral infarction.
血清蛋白和白蛋白水平降低与营养不良、功能状态受损、不良预后和死亡率升高显著相关。我们假设血清前白蛋白(转甲状腺素蛋白,PA)是年轻脑梗死患者可靠且稳健的生存标志物,并尝试验证上述假设。我们分析了 585 例年轻脑梗死患者的血清 PA 与出院时改良 Rankin 量表(mRS)确定的卒中严重程度之间的关系。通过多变量逻辑回归模型,我们确定了前白蛋白对卒中严重程度的影响,并对潜在混杂因素的影响进行了分析调整。严重卒中患者入院时血清前白蛋白水平在最低五分位数的患者更常见(P=0.031)。心源性脑梗死患者的血清前白蛋白浓度显著降低,mRS 评分更高。调整混杂因素的逻辑回归证实了以下独立(比值比,95%可信区间)良好预后预测因素:尿酸(-0.002,0.996-1.000)和前白蛋白(-0.003,0.995-1.000)。前白蛋白是年轻脑梗死患者临床良好结局的独立预测因素。血清前白蛋白可能是判断脑梗死预后的有用预后指标。