Abstract：
Nearly half of the patients undergoing endovascular treatment (EVT) do not have favorable outcomes despite successful recanalization of the occluded artery, which is also known as clinically ineffective reperfusion. We proposed a novel index-the systemic inflammatory protein index (SIPI), based on albumin, globulin, and C-reaction protein (CRP). We aimed to evaluate the relationship between inflammatory biomarkers at varying time points and the 90-day functional outcomes and investigate inflammatory biomarkers\' dynamic changes during hospitalization in acute ischemic stroke (AIS) patients of anterior circulation undergoing EVT. We retrospectively recruited consecutive patients diagnosed with AIS of anterior circulation and treated with EVT from January 2018 to June 2022 in Nanfang Hospital. Albumin, globulin, and CRP were recorded on admission, 1 day, 3 days, and 7 days after EVT. An unfavorable functional outcome was defined as 90-day modified Rankin Scale (mRS) of 3-6. Albumin-to-globulin ratio (AGR), C-reactive protein-to-albumin ratio (CAR), and SIPI were calculated as follows: AGR = albumin/globulin; CAR = CRP/albumin; SIPI = CRP × globulin/albumin. A total of 238 consecutive anterior circulation AIS patients with EVT were included, among which 145 (60.9%) patients had unfavorable outcomes. After adjusting for confounding factors, admission globulin, admission AGR, 1-day AGR, 3-day albumin, 3-day CRP, 3-day CAR, 3-day SIPI, 7-day albumin, 7-day CRP, 7-day CAR, and 7-day SIPI showed an independent association with 90-day functional outcome. Of them, 3-day SIPI had the most robust discriminative ability with an area under the curve of 0.719 (CI 0.630-0.808, p < 0.001). There were differences in the dynamic change of inflammatory biomarkers between the subjects with favorable and unfavorable functional outcomes. Inflammatory biomarkers, including albumin, globulin, CRP, AGR, CAR, and SIPI, are independent predictors of 90-day unfavorable outcomes in anterior circulation AIS patients with EVT. SIPI of day 3 has the highest predictive value.
摘要：
近半数接受血管内治疗（EVT）的患者虽然成功再通闭塞的动脉，但没有良好的结果。这也被称为临床无效再灌注。我们提出了一个新的指标-全身炎症蛋白指数（SIPI），基于白蛋白,球蛋白,C反应蛋白(CRP)。我们旨在评估不同时间点的炎症生物标志物与90天功能结局之间的关系，并研究接受EVT的急性缺血性卒中（AIS）患者住院期间炎症生物标志物的动态变化。我们回顾性招募2018年1月至2022年6月在南方医院诊断为前循环AIS并接受EVT治疗的连续患者。白蛋白,球蛋白,入院时记录CRP，1天,3天,EVT后7天。不利的功能结果定义为90天改良的Rankin量表（mRS）为3-6。白蛋白与球蛋白比（AGR），C反应蛋白与白蛋白之比（CAR），和SIPI计算如下:AGR=白蛋白/球蛋白;CAR=CRP/白蛋白;SIPI=CRP×球蛋白/白蛋白。共纳入238例伴有EVT的前循环AIS患者，其中145例(60.9%)患者出现不良结局.在调整混杂因素后，入院球蛋白,入学AGR，1天AGR,3天白蛋白，3天CRP,3天车,为期3天的SIPI，7天白蛋白，7天CRP,7天车，7日SIPI与90日功能结局存在独立关联.其中,3天SIPI具有最强大的辨别能力，曲线下面积为0.719（CI0.630-0.808，p<0.001）。在具有有利和不利功能结局的受试者之间，炎症生物标志物的动态变化存在差异。炎性生物标志物，包括白蛋白,球蛋白,CRP,AGR,汽车,和SIPI,是前循环AIS伴EVT患者90天不良结局的独立预测因子。第3天的SIPI具有最高的预测值。
