Predictive Value Of High Sensitivity C-reactive Protein/Albumin Ratio In Progressive Stroke

Objective:To study the risk factors of progressive ischemic stroke(PIS),and to explore the predictive value of high sensitivity C-reactive protein(hs-CRP)/albumin(ALB)ratio for the occurrence of PIS.Methods:From July 2019 to June 2020,155 patients with acute ischemic stroke who were hospitalized in the Department of Neurology of Cangzhou people’s Hospital,admitted within 24 hours of onset,and met the inclusion and exclusion criteria were selected.All patients were scored with the National Institutes of Health Stroke Scale(NIHSS)at admission and condition change.Baseline data and serum biochemical parameters were collected,and hs-CRP/ALB ratio was calculated.First,the patients were divided into PIS group and non PIS group according to whether the NIHSS score increased by more than 2 points within 6 hours to 7 days.The baseline data,serum biochemical indexes and hs-CRP/ALB of the two groups were compared.The risk factors of PIS were analyzed by binomial logistic regression.The receiver operating characteristic curve(ROC)was used Curve(ROC)was used to analyze the predictive value of ALB,hs-CRP and hs-CRP/ALB for the occurrence of PIS,and the best cut-off value and area under curve AUC of ALB,hs-CRP and hs-CRP/ALB were obtained.Combined with Delong method,the predictive ability of ALB,hs-CRP and hs-CRP/ALB for the occurrence of PIS was explored.According to the best cut-off value of hs-CRP/ALB,all patients were divided into high hs-CRP/ALB group and low hs-CRP/ALB group.Results:1 Comparison of baseline data between PIS group and non PIS groupOnly age factor had statistical difference between the two groups(P<0.05).There was no significant difference in gender,history of hypertension,history of diabetes,history of coronary heart disease and systolic blood pressure at admission between the two groups(P>0.05).2 Comparison of serum biochemical indexes between PIS group and non PIS groupThere were significant differences in the distribution width of red blood cells,D-dimer and fibrin degradation products(P<0.05).There was no significant difference between the two groups in the distribution width of homocysteine,plasma fibrinogen,LDL,cholesterol,lipoprotein A,uric acid and platelet(P>0.05).3 Comparison of ALB,hs-CRP and hs-CRP/ALB between PIS group and non PIS groupThere were significant differences in ALB,hs-CRP and hs-CRP/ALB between the two groups(P<0.001).4 Analysis of related risk factors affecting the occurrence of PISUnivariate logistic regression analysis results: age,red blood cell distribution width,hs-CRP,ALB,hs-CRP/ALB were risk factors of PIS(P <0.05).Multivariate logistic regression analysis results: age,plasma fibrinogen,hs-CRP and ALB were risk factors of PIS(P < 0.05)..5 Comparison of ALB,hs-CRP and hs-CRP/ALB in the diagnosis of PISROC curves of ALB,hs-CRP and hs-CRP/ALB were drawn.The area under curve(AUC)were 0.684,0.786 and 0.803 respectively,and AUC were all greater than 0.5.All of them had predictive value for the occurrence of PIS.The AUC value of hs-CRP/ALB was the highest.The AUC values of ALB and hs-CRP were significantly different from those of hs-CRP/ALB(P<0.05).When the Youden index was the largest,the cutoff value of hs-CRP/ALB was 0.054,the sensitivity was 63.6%,the specificity was84.6%;the cutoff value of hs-CRP was 2.1,the sensitivity was 66.2%,the specificity was 79.5%;the cutoff value of ALB was 41.05,the sensitivity was 76.9%,the specificity was 45.5%.6 Comparison of clinical data between high hs-CRP/ALB group and low hs-CRP/ALB groupThere were significant differences in the types of stroke(PIS and non PIS)and hs-CRP between the two groups(P<0.05).Compared with low hs-CRP/ALB group,high hs-CRP/ALB group had higher hs-CRP level and higher proportion of PIS type.Conclusion:1 Age,plasma fibrinogen and hs-CRP were the risk factors of PIS,while ALB was the protective factor.2 ALB,hs-CRP and hs-CRP/ALB have predictive value for the occurrence of PIs,and hs-CRP/ALB has the greatest predictive value.