The Predictive Value Of Hypersensitive C-reactive Protein To Albumin Ratio In The Prognosis Of Acute Mild To Moderate Cerebral Infarction

Objective:Explore the relationship between the hypersensitive C-reactive protein to albumin ratio（hs-CRP/ALB）and the 30-day and 90-day prognosis of patients with acute mild to moderate cerebral infarction.To evaluate the predictive value of hs-CRP/ALB for the prognosis of patients with acute mild to moderate cerebral infarction and determine the cut-off value.Methods:A retrospective collection of patients with acute mild to moderate cerebral infarction who were admitted to the Department of Neurology of the First Hospital of Handan City from October 2019 to September 2020 were collected.Collect demographic data,vascular risk factors,imaging data,NIHSS,admission baseline blood pressure,and laboratory indicators including hs-CRP and ALB of the enrolled patients,and divide the hs-CRP in the same test by ALB to get hs-CRP/ALB;Follow up 30 days and 90 days after cerebral infarction and record the modified Rankin scale.According to the results of m RS score,m RS≤2 is divided into good prognosis group,and m RS>2 is divided into poor prognosis group.Compare the distribution of the included indicators in the prognostic groups of patients with acute mild to moderate cerebral infarction.Multivariate logistic regression analysis was used to explore the factors affecting the prognosis of patients with acute mild to moderate cerebral infarction.The receiver operating characteristic curve was used to evaluate the predictive value of hs-CRP/ALB on the neurological prognosis of patients with acute mild to moderate cerebral infarction.Results:（1）A total of 224 patients were included in the 30-day prognosis analysis,of which 167 cases（74.6%）had a good prognosis and 57 cases（25.4%）had a poor prognosis.Univariate analysis showed that there were significant differences between two groups in gender,smoking,prealbumin,total bilirubin,triglycerides,glycosylated hemoglobin and hs-CRP/ALB.Multivariate analysis showed that total bilirubin,glycosylated hemoglobin,triglycerides,prealbumin,hs-CRP/ALB were independent factors affecting the 30-day prognosis of acute mild to moderate cerebral infarction（P<0.05）.（2）A total of 211 patients were included in the 90-day prognosis analysis,of which 167 cases（79.1%）had a good prognosis and 44 cases（20.9%）had a poor prognosis.Univariate analysis showed that there were significant differences between two groups in gender,baseline NIHSS,prealbumin,total bilirubin,glycosylated hemoglobin and hs-CRP/ALB.Multivariate analysis showed that baseline NIHSS,total bilirubin,glycosylated hemoglobin,and prealbumin were independent factors influencing the prognosis of acute mild to moderate cerebral infarction at 90 days（P<0.05）.（3）ROC curve results show that the area under the curve for hs-CRP/ALB to predict the 30-day prognosis is 0.713,the best cut-off value is 10.17x10^-2,the specificity of predicting 30-day prognosis is 86.83%,and the sensitivity of predicting 30-day prognosis is 71.93%.Conclusions:hs-CRP/ALB can be used as an independent risk factor for the prognosis of acute mild to moderate cerebral infarction at 30 days,while hs-CRP/ALB cannot be used as an independent predictor of the prognosis of acute mild to moderate cerebral infarction at 90 days.The critical value of hs-CRP/ALB for predicting the poor prognosis of acute mild to moderate cerebral infarction at 30 days is 10.17x10^-2.