Department of Neurology, Nanjing First Hospital, Nanjing Medical University, No. 68 Changle Road, Nanjing, 210006, P.R. China.
Department of Neurology, Nanjing Yuhua Hospital, Nanjing First Hospital, Nanjing Medical University, Nanjing, 210006, Jiangsu, China.
BMC Neurol. 2021 Feb 1;21(1):47. doi: 10.1186/s12883-021-02066-2.
Approximately 10% of patients would develop symptomatic intracranial hemorrhage (sICH) after endovascular therapy. The aim of our study was to explore the ability of hypersensitive C-reactive protein-albumin ratio (HAR) in predicting sICH after endovascular therapy.
From April 2016 to December 2018, 334 consecutive patients with anterior circulation infarction undergoing endovascular therapy were enrolled in our study. sICH was defined using Heidelberg bleeding classification after endovascular therapy. Multiple regression analysis was used to investigate the potential risk factors of sICH after endovascular therapy. We used receiver operating characteristic curve analysis and nomogram analysis to assess the overall discriminative ability of the HAR in predicting sICH after endovascular therapy.
Among these 334 patients enrolled, 37 (11.1%) patients with anterior circulation infarction were identified with sICH after endovascular therapy. Univariate logistic regression analysis demonstrated that patients with higher levels of HAR may be inclined to develop sICH (odds ratio, 10.994; 95% confidence interval, 4.567-26.463; P = 0.001). This association remained significant even after adjustment for potential confounders. Also, a cutoff value of 0.526× 10 for HAR was detected in predicting sICH (area under curve, 0.763). Furthermore, nomogram analysis also suggested that HAR was an indicator of sICH (c-index was 0.890, P< 0.001).
This study showed that high levels of HAR could predict sICH after endovascular therapy.
大约 10%的患者在血管内治疗后会出现症状性颅内出血（sICH）。我们的研究目的是探讨超敏 C 反应蛋白-白蛋白比值（HAR）预测血管内治疗后 sICH 的能力。
本研究纳入了 2016 年 4 月至 2018 年 12 月期间 334 例接受血管内治疗的前循环梗死患者。血管内治疗后采用海德堡出血分类定义 sICH。采用多元回归分析探讨血管内治疗后 sICH 的潜在危险因素。我们使用受试者工作特征曲线分析和列线图分析评估 HAR 预测血管内治疗后 sICH 的整体判别能力。
在纳入的 334 例患者中，37 例（11.1%）前循环梗死患者血管内治疗后发生 sICH。单因素 logistic 回归分析表明，HAR 水平较高的患者可能更容易发生 sICH（比值比，10.994；95%置信区间，4.567-26.463；P=0.001）。即使在调整了潜在混杂因素后，这种相关性仍然显著。此外，检测到 HAR 的截断值为 0.526×10 可预测 sICH（曲线下面积，0.763）。此外，列线图分析也表明 HAR 是 sICH 的指标（c 指数为 0.890，P<0.001）。
本研究表明，HAR 水平升高可预测血管内治疗后 sICH。
