Zhu Xu, Zhang Yijun, Wang Anxin, Zhang Xiaoli, Yu Guoyuan, Xiang Shifeng, Wu Yiping, Meng Xia
Department of Neurology, Handan Central Hospital, Handan, China.
Department of Neurology, Beijing Tiantan Hospital, Capital Medical University, Beijing, China.
Front Neurol. 2025 Jan 7;15:1461188. doi: 10.3389/fneur.2024.1461188. eCollection 2024.
The combined index (HALP) of hemoglobin, albumin, lymphocytes, and platelets is considered a novel scoring system that reflects systemic inflammation and nutritional status. This study aimed to investigate the relationship between HALP scores and poor outcomes in acute ischemic stroke (AIS) patients with type 2 diabetes mellitus (DM).
Patients with AIS and type 2 DM were screened from the Third China National Stroke Registry (CNSR-III) and divided into quartiles based on their HALP scores at admission. Clinical outcomes were adverse functional outcomes (modified Rankin scale [mRS] score of 3-6 or 2-6) and all-cause mortality at 3 months and 1 year. The association of HALP with the risk of poor functional outcome and all-cause mortality were analyzed by multivariable logistic regression and Cox proportional hazards regression.
A total of 3,603 patients were included in this study. After adjusting for confounders, it was found that patients in the highest HALP score quartile had lower mRS scores of 2-6 (odds ratio [OR], 0.64; 95% confidence interval [CI], 0.51-0.80) and 3-6 (OR, 0.53; 95% CI, 0.51-0.82) at the 3-month follow-up. At the 1-year follow-up, a significant correlation was observed between HALP scores and mRS scores of 2-6 (OR, 0.65; 95%CI, 0.57-0.81) and 3-6 (OR, 0.64; 95%CI, 0.47-0.86). Additionally, the highest HALP score quartile was associated with a reduced risk of all-cause mortality at the 3-month follow-up (hazard ratio [HR], 0.35; 95%CI, 0.13-0.93). Similar results were observed at the 1-year follow-up (HR, 0.34; 95%CI, 0.18-0.63).
At 3 months of AIS patients with type 2 diabetes and 1-year follow-up, lower HALP scores were associated with poorer functional outcomes and all-cause mortality.
血红蛋白、白蛋白、淋巴细胞和血小板的联合指数（HALP）被认为是一种反映全身炎症和营养状况的新型评分系统。本研究旨在探讨2型糖尿病（DM）急性缺血性卒中（AIS）患者HALP评分与不良预后之间的关系。
从中国国家卒中登记系统三期（CNSR-III）中筛选出AIS合并2型DM的患者，并根据入院时的HALP评分将其分为四分位数。临床结局为3个月和1年时的不良功能结局（改良Rankin量表[mRS]评分为3-6或2-6）和全因死亡率。通过多变量逻辑回归和Cox比例风险回归分析HALP与不良功能结局风险和全因死亡率的关联。
本研究共纳入3603例患者。在调整混杂因素后，发现HALP评分最高四分位数的患者在3个月随访时mRS评分为2-6（优势比[OR]，0.64；95%置信区间[CI]，0.51-0.80）和3-6（OR，0.53；95%CI，0.51-0.82）的比例较低。在1年随访时，观察到HALP评分与mRS评分为2-6（OR，0.65；95%CI，0.57-0.81）和3-6（OR，0.64；95%CI，0.47-0.86）之间存在显著相关性。此外，HALP评分最高四分位数与3个月随访时全因死亡率风险降低相关（风险比[HR]，0.35；95%CI，0.13-0.93）。在1年随访时观察到类似结果（HR，0.34；95%CI，0.18-0.63）。
在2型糖尿病AIS患者3个月及1年随访时，较低的HALP评分与较差的功能结局和全因死亡率相关。
