纤维蛋白原/白蛋白比值与脑小血管病总负荷评分的相关性及对急性缺血性脑卒中患者早期神经功能恶化的预测价值OA

Objective To investigate the association between fibrinogen-to-albumin ratio(FAR)and the overall burden of cerebral small vessel disease(CSVD),as well as their value in predicting early neurological deterioration(END)in patients with acute ischemic stroke(AIS).Methods A total of 103 AIS patients who were admitted to our hospital from January 2023 to March 2025 were enrolled.According to the CSVD total burden score,the patients were divided into low burden group(0-2 points)with 58 patients and high burden group(3-4 points)with 45 patients;According to the pres-ence or absence of END,they were divided into END group with 21 patients and non-END group with 82 patients.The weighted generalized additive model combined with smooth curve fitting was used to investigate the correlation between FAR and CSVD total burden score.A logistic regression analysis was used to explore the association of FAR and CSVD to-tal burden score with the prognosis of END in AIS patients.The receiver operating characteristic(ROC)curve was used to assess the value of FAR and CSVD total burden score in predicting END in AIS patients.The restricted cubic spline method was used to analyze the dose-response relationship between FAR and END in AIS patients.The Bootstrap method was used to investigate the mediating effect of CSVD total burden score in the relationship between FAR and END in AIS pa-tients.Results The high burden group had a significantly higher FAR than the low burden group(P<0.05),and there was a U-shaped relationship between FAR and CSVD total burden score,with an inflection point of 8.14%.Compared with the non-END group,the END group had a significantly higher proportion of patients with a CSVD total burden score of 3-4 points and a significantly higher FAR(P<0.05).After adjustment for the covariates such as age and sex,FAR(OR=1.918,95%CI 1.825-2.157,P<0.05)and CSVD global burden score(OR=2.167,95%CI 2.051-2.249,P<0.05)were still independently associated with the risk of END in AIS patients.FAR combined with CSVD total load score had a signifi-cantly higher predictive value than either indicator alone,with an area under the ROC curve of 0.951.The mediating effect analysis showed that CSVD total burden score played a mediating effect between FAR and AIS patient prognosis END(P<0.05).Conclusion There is a significant association between FAR and the overall burden of CSVD,and combined mea-surement of FAR and CSVD total burden score can significantly enhance the performance in predicting END,thereby pro-viding an important basis for developing individualized treatment strategies in clinical practice.