【摘要】 目的 探讨高纤维蛋白原/白蛋白比(FAR)与急性前循环大动脉粥样硬化型脑梗死患者早期临床预后的相关性。方法 收集2022年1月至2025年1月河北医科大学第二医院神经内科收治的2500例急性前循环大动脉粥样硬化型脑梗死后72 h内的患者临床资料,并随访3个月。根据发病3个月后改良Rankin量表(MRS)评分将患者分为预后良好组和预后不佳组。比较两组患者的临床特征、实验室指标及梗死体积,采用多因素Logistic回归分析FAR与预后的独立关系,并通过受试者工作特征(ROC)曲线确定FAR预测预后的最佳截断值。结果 预后不佳组患者的白细胞计数、中性粒细胞计数、中性粒细胞/淋巴细胞比值(NLR)、FAR、空腹血糖、梗死体积及入院NIHSS评分均显著高于预后良好组(P<0.05),而淋巴细胞计数和嗜酸性粒细胞/中性粒细胞比值(ENR)显著降低(P<0.05)。ROC曲线分析显示,FAR预测预后的最佳截断值为0.0908,敏感性为61.86%,特异性为85.37%,曲线下面积(AUC)为0.740。多因素Logistic回归分析显示,调整NIHSS评分和梗死体积后高FAR仍为患者3个月预后不佳的独立危险因素。结论 高FAR是急性前循环大动脉粥样硬化型脑梗死患者3个月预后不佳的独立危险因素,早期检测FAR有助于评估患者预后。更多还原

【Abstract】 Objective To investigate the correlation between elevated fibrinogen-to-albumin ratio(FAR) and early clinical outcomes in patients with acute anterior circulation atherosclerotic cerebral infarction.Methods Clinical data were collected from 2,500 patients with acute anterior circulation atherosclerotic cerebral infarction admitted to Department of Neurology,the Second Hospital of Hebei Medical University between January 2022 and January2025 within 72 hours of onset,with a 3-month follow-up.Patients were categorized into favorable and unfavorable prognosis groups based on modified Rankin scale(MRS) scores at 3 months post-onset.Clinical characteristics,laboratory indicators,and infarct volume were compared between groups.Multivariate Logistic regression analyzed the independent relationship between FAR and prognosis.The optimal cutoff value for FAR in predicting prognosis was determined using receiver operating characteristic(ROC) curves.Results Patients in the poor prognosis group exhibited significantly higher white blood cell count,neutrophil count,neutrophil-to-lymphocyte ratio(NLR),fasting blood glucose,infarct volume,and admission NIHSS score compared to the good prognosis group(P <0.05).Lymphocyte ratio(NLR),FAR,fasting blood glucose,infarct volume,and admission NIHSS scores were significantly higher than those in the favorable prognosis group(P <0.05),while lymphocyte count and eosinophil/neutrophil ratio(ENR) were significantly lower(P <0.05).ROC curve analysis indicated that the optimal cutoff value for FAR predicting prognosis was 0.0908,with a sensitivity of 61.86%,specificity of 85.37%,and AUC were 0.740.Multivariate Logistic regression analysis revealed that elevated FAR remained an independent risk factor for poor 3-month prognosis after adjusting for NIHSS score and infarct volume.Conclusion Elevated FAR is an independent risk factor for poor 3-month prognosis in patients with acute anterior circulation atherosclerotic cerebral infarction.Early detection of FAR aids in assessing patient prognosis.更多还原