Xuzhou Central Hospital, China.
Folia Neuropathol. 2024;62(2):187-196. doi: 10.5114/fn.2024.139871.
The aim of the study was to explore the value of serum procalcitonin to albumin (PCT/ALB) and C-reactive protein to albumin (CRP/ALB) ratios in evaluating the condition and prognosis of craniocerebral trauma (CT).
158 patients with CT admitted to the emergency department of our hospital from January 2020 to June 2022 were selected as the study subjects. According to the Glasgow coma scale (GCS) score, 158 patients with CT were grouped in a mild group (GCS score 13-15 points, n = 68), a moderate group (GCS score 9-12 points, n = 61), and a severe group (GCS score 3-8 points, n = 29). Besides, according to the patient's Glasgow prognosis (GOS) score, 158 patients with CT were divided into a good prognosis group (GOS score 4-5 points, n = 110) and a poor prognosis group (GOS score 1-3 points, n = 48). Serum PCT/ALB and CRP/ALB levels of different groups were compared. The correlation between PCT/ALB and CRP/ALB ratios and the score of GCS and GOS was explored using Pearson correlation analysis. Prognosis-related influencing factors were found out through multivariate logistic regression. The value of serum PCT/ALB and CRP/ALB ratios in evaluating the condition and prognosis of CT was evaluated by the ROC curve.
Patients in the moderate and severe groups had much higher ratios of PCT/ALB and CRP/ALB and sharply lower GCS scores than those in the mild group ( p < 0.001). Compared with the patients in the moderate group, those in the severe group had much higher PCT/ALB and CRP/ALB ratios and obviously lower GCS scores ( p < 0.001). Patients with poor prognosis had markedly higher PCT/ALB and CRP/ALB ratios and memorably lower GOS score than the patients with good prognosis ( p < 0.001). A negative correlation between PCT, CRP, PCT/ALB ratio, CRP/ALB ratio and GCS scores ( r = -0.821, -0.857, -0.750, -0.766, p < 0.001) and GOS scores ( r = -0.636, -0.628, -0.595, -0.628, p < 0.001) was revealed by Pearson correlation analysis. ALB was correlated positively with GCS score and GOS score ( r = 0.381, 0.413, p < 0.001). Multivariate logistic regression analysis exhibited that PCT/ALB ratio and CRP/ALB ratio were related to poor prognosis of CT patients ( p < 0.05). ROC curve analysis showed that the combined PCT/ALB ratio and CRP/ALB area under the curve (AUC) were 0.883 and 0.860, respectively, which were used to assess the severity and predict prognosis of patients with CT.
PCT/ALB and CRP/ALB ratios were positively correlated with the severity and prognosis of patients with CT, and were risk factors for poor prognosis. Early determination of changes in PCT/ALB and CRP/ALB ratios had a certain clinical value for evaluating the condition and prognosis of CT patients.
本研究旨在探讨血清降钙素原/白蛋白（PCT/ALB）和 C 反应蛋白/白蛋白（CRP/ALB）比值在评估颅脑外伤（CT）患者病情和预后中的价值。
选取 2020 年 1 月至 2022 年 6 月我院急诊科收治的 158 例 CT 患者为研究对象。根据格拉斯哥昏迷评分（GCS），将 158 例 CT 患者分为轻度组（GCS 评分 13-15 分，n=68）、中度组（GCS 评分 9-12 分，n=61）和重度组（GCS 评分 3-8 分，n=29）。此外，根据患者的格拉斯哥预后（GOS）评分，将 158 例 CT 患者分为预后良好组（GOS 评分 4-5 分，n=110）和预后不良组（GOS 评分 1-3 分，n=48）。比较不同组的血清 PCT/ALB 和 CRP/ALB 水平。采用 Pearson 相关分析探讨 PCT/ALB 与 CRP/ALB 比值与 GCS 和 GOS 评分的相关性。采用多因素 logistic 回归分析找出预后相关的影响因素。通过 ROC 曲线评估血清 PCT/ALB 和 CRP/ALB 比值在评估 CT 患者病情和预后中的价值。
中度组和重度组患者的 PCT/ALB 和 CRP/ALB 比值明显高于轻度组，GCS 评分明显低于轻度组（p<0.001）。与中度组患者相比，重度组患者的 PCT/ALB 和 CRP/ALB 比值明显更高，GCS 评分明显更低（p<0.001）。预后不良组患者的 PCT/ALB 和 CRP/ALB 比值明显高于预后良好组，GOS 评分明显低于预后良好组（p<0.001）。Pearson 相关分析显示，PCT、CRP、PCT/ALB 比值、CRP/ALB 比值与 GCS 评分（r=-0.821、-0.857、-0.750、-0.766，p<0.001）和 GOS 评分（r=-0.636、-0.628、-0.595、-0.628，p<0.001）呈负相关。ALB 与 GCS 评分和 GOS 评分呈正相关（r=0.381、0.413，p<0.001）。多因素 logistic 回归分析显示，PCT/ALB 比值和 CRP/ALB 比值与 CT 患者的不良预后有关（p<0.05）。ROC 曲线分析显示，PCT/ALB 比值和 CRP/ALB 比值联合的曲线下面积（AUC）分别为 0.883 和 0.860，可用于评估 CT 患者的严重程度和预测预后。
PCT/ALB 和 CRP/ALB 比值与 CT 患者的病情和预后呈正相关，是预后不良的危险因素。早期测定 PCT/ALB 和 CRP/ALB 比值的变化对评估 CT 患者的病情和预后具有一定的临床价值。
