Department of Neurology, Beijing Tiantan Hospital, Capital Medical University, Beijing, China; China National Clinical Research Center for Neurological Diseases, Capital Medical University, Beijing, China.
China National Clinical Research Center for Neurological Diseases, Capital Medical University, Beijing, China.
J Stroke Cerebrovasc Dis. 2024 Dec;33(12):108026. doi: 10.1016/j.jstrokecerebrovasdis.2024.108026. Epub 2024 Sep 24.
The C-reactive protein-to-albumin ratio (CAR) is a novel prognostic biomarker of systemic inflammation and nutritional status. The association between CAR and the long-term outcome of spontaneous intracerebral hemorrhage (ICH) remains unclear.
From January 2014 to September 2016, 497 patients with spontaneous ICH were enrolled in our study from 13 hospitals in Beijing. According to the CAR quartiles, patients were classified into four groups (Q1-Q4). Logistic regression was applied to analyze the relationship between different CAR levels and main outcome (90-day and 1-year mRS 4-6). Restricted cubic splines and receiver operating characteristic (ROC) curves of CAR for poor clinical outcomes were assessed.
In the multivariate logistic regression model, compared with the lowest quartile of CAR, the adjusted odds ratios of the Q2, Q3, and Q4 group for 90-day mRS score of 4-6 were 3.64 (1.61-8.23), 3.83 (1.67-8.77), and 8.91 (3.85-20.64). In terms of 1-year mRS score of 4-6, compared with the lowest quartile of CAR, the adjusted odds ratios of the Q3 and Q4 group were 3.31 (1.33-8.22) and 6.87 (2.81-16.78).
A high CAR level was associated with a high risk of long-term adverse prognosis in patients with ICH, and the risk of ICH poor outcome increased steadily with CAR rising in a certain range, and maintained in a high level thereafter.
C 反应蛋白与白蛋白比值（CAR）是一种新的全身性炎症和营养状态的预后生物标志物。CAR 与自发性脑出血（ICH）长期预后之间的关系尚不清楚。
本研究纳入了 2014 年 1 月至 2016 年 9 月期间来自北京 13 家医院的 497 例自发性 ICH 患者。根据 CAR 四分位数，患者被分为四组（Q1-Q4）。采用逻辑回归分析不同 CAR 水平与主要结局（90 天和 1 年 mRS 4-6）之间的关系。评估了 CAR 对不良临床结局的受限立方样条和受试者工作特征（ROC）曲线。
在多变量逻辑回归模型中，与 CAR 最低四分位数相比，Q2、Q3 和 Q4 组 90 天 mRS 评分 4-6 的校正比值比分别为 3.64（1.61-8.23）、3.83（1.67-8.77）和 8.91（3.85-20.64）。在 1 年 mRS 评分 4-6 方面，与 CAR 最低四分位数相比，Q3 和 Q4 组的校正比值比分别为 3.31（1.33-8.22）和 6.87（2.81-16.78）。
高 CAR 水平与 ICH 患者长期不良预后风险增加相关，且在一定范围内，随着 CAR 的升高，ICH 不良结局的风险呈稳步上升趋势，并保持在较高水平。
