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血红蛋白、白蛋白、淋巴细胞和血小板(HALP)评分是否是机械取栓治疗大脑中动脉梗死患者死亡率的新型生物标志物?

Is the hemoglobin, albumin, lymphocyte, and platelet (HALP) score a novel biomarker for predicting mortality in patients with middle cerebral artery infarctions undergoing mechanical thrombectomy?

机构信息

Department of Neurology, Bursa City Hospital, Turkey.

Department of Radiology, Bursa City Hospital, Turkey.

出版信息

Clin Neurol Neurosurg. 2024 Dec;247:108598. doi: 10.1016/j.clineuro.2024.108598. Epub 2024 Oct 22.

Abstract

BACKGROUND

The hemoglobin, albumin, lymphocyte, and platelet (HALP) score, easily calculated parameter, indicating systemic inflammation and nutritional status INTRODUCTION: In this study, we used the HALP score in patients with acute ischemic stroke (AIS) undergoing mechanical thrombectomy (MT) to predict 90-day mortality.

METHOD

122 patients with AIS who underwent either MT or MT and tissue plasminogen activator (tPA) for middle cerebral artery (MCA) M1 occlusion. The HALP score was calculated, demographic data, modified Rankin Scale (mRS) score, and mortality status in retrospectively reviewed. The effectiveness of the HALP score in predicting mortality within 90 days was assessed using the receiver operating characteristic ( ROC) curves. The optimal cutoff value for HALP was 13.10.

RESULTS

A HALP score <13.10 increased the risk of death within 90 days and was associated with a higher incidence of large artery thrombosis. Cardioembolism and hyperlipidemia were more common in patients with high (>13) HALP scores. In addition to the HALP score, the length of hospital stay, 24-h National Institutes of Health Stroke Scale score (NIHSS), number of days of intubation, acute physiologic assessment and chronic health evaluation (APACHE) II score, and symptom-to-groin time were statistically significant risk factors for mortality within 90 days.

DISCUSSION

The HALP score is an easily calculated, inexpensive, and noninvasive parameter that can be used to predict mortality in patients with MCA M1 occlusion undergoing reperfusion therapy. Low HALP scores indicate a poor prognosis. Thus, there is a relationship between the HALP score and survival.

摘要

背景

血红蛋白、白蛋白、淋巴细胞和血小板(HALP)评分是一个易于计算的参数,可反映全身炎症和营养状态。

介绍

本研究采用 HALP 评分评估接受机械取栓(MT)治疗的急性缺血性脑卒中(AIS)患者的 90 天死亡率。

方法

回顾性分析 122 例接受 MT 或 MT 联合组织型纤溶酶原激活剂(tPA)治疗大脑中动脉(MCA)M1 段闭塞的 AIS 患者的资料,计算 HALP 评分、人口统计学数据、改良 Rankin 量表(mRS)评分和死亡率。采用受试者工作特征(ROC)曲线评估 HALP 评分预测 90 天死亡率的效能。HALP 的最佳截断值为 13.10。

结果

HALP<13.10 评分增加 90 天内死亡风险,且与大血管血栓形成发生率升高相关。高(>13)HALP 评分患者更常见心源性栓塞和高脂血症。除 HALP 评分外,住院时间、24 小时国立卫生研究院卒中量表(NIHSS)评分、插管天数、急性生理与慢性健康评估(APACHE)Ⅱ评分和症状至股动脉穿刺时间也是 90 天内死亡的统计学显著危险因素。

讨论

HALP 评分是一种易于计算、经济且非侵入性的参数,可用于预测接受再灌注治疗的 MCA M1 段闭塞患者的死亡率。低 HALP 评分提示预后不良。因此,HALP 评分与生存之间存在关联。

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