急性缺血性脑卒中后血清白蛋白与神经功能预后的u型关系：一项前瞻性队列研究。

IF 3.9 3区医学 Q1 CLINICAL NEUROLOGY

Neurology and Therapy Pub Date : 2025-06-01 Epub Date: 2025-04-16 DOI:10.1007/s40120-025-00729-7

Yuan Zhu, Gang Xue, Shufan Xu, Qi Qin, Peian Liu, Lianhong Ji, Huimin Wu, Minghua Wu, Zhuyuan Fang

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引用次数: 0

摘要

几项研究表明，血清白蛋白（SA）水平低的急性缺血性卒中（AIS）患者预后较差。然而，静脉注射25%的白蛋白，剂量为2g /kg，并没有改善AIS患者90天后的预后。我们的目的是在一项前瞻性队列调查中检查SA水平与卒中结局之间可能的相关性。方法：本研究共纳入5111名诊断为AIS的参与者。通过单因素和多因素logistic分析，检验发病后90天SA水平与改良Rankin量表（mRS）评分的相关性。采用限制三次样条检验了这些关系。采用中介分析方法，考虑低密度脂蛋白（LDL）的中介作用，对SA水平与神经功能结果之间的关系进行了调查。此外，采用逻辑回归进行亚组分析。结果：SA水平与AIS后神经功能预后呈u型关系。随着SA的升高，阴性结果的可能性显著降低(每g/L: OR（比值比）0.88；SA水平低于42.2 g/L个体的95% CI（置信区间）为0.847 ~ 0.913。相反，在SA水平为42.2 g/L或更高的人群中，随着SA（每g/L: OR 1.033, 95% CI 1.009-1.058）的增加，阴性结果的可能性增加。死亡率结果也有类似的发现。一项中介研究显示LDL在SA水平与神经功能结局之间的统计学关联中具有中介作用，占关联的12.3%。在任何一组中都没有发现明显的相互作用。结论：在AIS患者中，入院时SA水平与不良预后的可能性呈u型关系，其中部分由LDL介导。本文有一个图形摘要。

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U-Shaped Relationship of Serum Albumin and Neurological Functional Outcomes After Acute Ischemic Stroke: A Prospective Cohort Study.

Introduction: Several studies indicate that individuals with acute ischemic stroke (AIS) who have low levels of serum albumin (SA) have a dismal prognosis. However, intravenously administering albumin 25% at a dose of 2 g/kg did not lead to improved outcomes for patients with AIS after 90 days. Our objective was to examine the possible correlation between SA levels and stroke outcomes in a prospective cohort investigation.

Methods: The research included a total of 5111 participants diagnosed with AIS. The correlation between SA level and modified Rankin Scale (mRS) scores 90 days after onset was examined via univariate and multivariate logistic analyses. The relationships were examined employing restricted cubic splines. An investigation was conducted to ascertain the connection between SA levels and neurological functional results by employing mediation analysis, with the mediation impact of low-density lipoprotein (LDL) taken into account. In addition, the subgroup analyses were performed using the logistic regression.

Results: The connection between levels of SA and neurological functional outcomes following AIS exhibited a U-shaped pattern. The likelihood of a negative result dropped significantly with an elevation in SA (per g/L: OR (odds ratio) 0.88; 95% CI (confidence interval) 0.847-0.913) among individuals with SA levels below 42.2 g/L. Conversely, the likelihood of a negative outcome rose with an increase in SA (per g/L: OR 1.033, 95% CI 1.009-1.058) among people with SA levels of 42.2 g/L or above. Comparable findings were seen for mortality outcomes. A mediation study revealed that LDL had a mediating function in the statistical connection between SA levels and neurological functional outcomes, accounting for 12.3% of the connection. No significant interactions were seen in any of the groupings.

Conclusion: Among patients with AIS, there was a U-shaped relationship between SA levels at admission and the likelihood of poor outcomes, which was partially mediated by LDL. There is a Graphical Abstract available for this article.

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来源期刊

Neurology and Therapy CLINICAL NEUROLOGY-

CiteScore

5.40

自引率

8.10%

发文量

103

审稿时长

6 weeks

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