关键词: 白蛋白, 白细胞介素6, 铁蛋白, 自发性脑出血, 预后

Abstract:

Objective To investigate the role of serum albumin，interleukin-6（IL-6） and ferritin combined determination in evaluating the functional prognosis of patients with spontaneous intracerebral hemorrhage（SICH）. Methods A total of 148 patients with SICH treated at Hai'an People's Hospital from January 2018 to January 2021 were enrolled. Patients' clinical，laboratory and imaging data were collected，and serum albumin，IL-6 and ferritin were determined before treatment. According modified Rankin scale（mRS） scores，the patients were classified into good prognosis group（mRS<3） and poor prognosis group（mRS≥3），and the patients were followed up for 90 d. Receiver operating characteristic（ROC） curve was used to determine the discriminative capability of various parameters for 90 d functional prognosis and death. Binary Logistic regression analysis was used to determine the factors for 90 d functional prognosis. Results Compared with good prognosis group，poor prognosis group had higher the National Institute of Health Stroke Scale（NIHSS） score，hematoma volume，perihematoma edema volume，white blood cell count，IL-6 and ferritin and lower serum albumin（P<0.05），while the difference for the other parameters were not statistically significant between the 2 groups（P>0.05）. The results of Pearson correlation analysis showed serum albumin and perihematoma edema volume was negatively correlated（r=-0.32，P<0.01），and ferritin was positively correlated with hematoma volume（r=0.27，P<0.01）. The results of binary Logistic regression analysis showed that hematoma volume，cerebral hemorrhage site，serum albumin，IL-6 and ferritin were prognostic factors for the functional prognosis of SICH patients at 90 d of onset（P<0.05）. Binary Logistic regression analysis was used to construct a combined determination model based on the above influencing factors. The results of ROC curve analysis showed that the areas under curves（AUC） of serum albumin，IL-6，ferritin alone and combined determination model for the functional prognosis of SICH patients at 90 d of onset were 0.68，0.65，0.62 and 0.94，respectively. The AUC of serum albumin，IL-6 and ferritin for judging death of SICH patients at 90 d of onset were 0.68，0.68 and 0.51，respectively. The AUC of serum albumin and IL-6 combined determination model and serum albumin，IL-6，hematoma volume and cerebral hemorrhage site combined determination model for judging death of SICH patients at 90 d of onset were 0.76 and 0.90，respectively. Conclusions Serum albumin，IL-6 and ferritin combined determination with cerebral hemorrhage site and hematoma volume help to accurately assess the functional prognosis and death at 90 d of onset in patients with SICH.

Key words: Albumin, Interleukin-6, Ferritin, Spontaneous intracerebral hemorrhage, Prognosis