白蛋白校正阴离子间隙对急性缺血性脑卒中患者静脉溶栓后出血转化结局的预测价值OA

Objective To investigate the predictive value of albumin-corrected anion gap(ACAG)in hemorrhagic transformation(HT)after intravenous thrombolysis in patients with acute ischemic stroke.Methods A total of 184 patients with acute ischemic stroke who received intravenous thrombolytic therapy in Mingji Hospital Affiliated to Nanjing Medical U-niversity from September 2021 to September 2024 were selected.They were divided into an HT group(n=39)and a non-HT group(n=145)based on whether HT occurred within 48 hours after thrombolytic therapy.Baseline data and relevant laborato-ry indicators on the first day of admission were collected.Multivariate logistic regression was used to analyze the influencing factors of HT occurrence in patients,and ROC curve analysis was employed to assess the predictive value of ACAG for HT occurrence in stroke patients.Results The levels of CRP,Cl-,HCO3-,and Alb in the HT group were lower than those in the non-HT group(P＜0.05),while the levels of AG and ACAG in the HT group were higher than those in the non-HT group(P＜0.05).Multivariate logistic regression analysis showed that ACAG[OR=14.145,95％CI:3.078-64.645],AG[OR=2.983,95％CI:1.859-4.758],CRP[OR=2.428,95％CI:1.101-12.082],and NIHSS score at admission[OR=3.147,95％CI:1.906-5.168]were all influencing factors for HT in stroke patients(P＜0.05).ROC curve analysis results showed that ACAG had higher predictive efficiency than other indicators,with an AUC of 0.872(95％CI:0.767-0.972),sensitivity of 0.725,spe-cificity of 0.973,Youden index of 0.698,and an optimal cutoff value of 18.010 mmol/L(P＜0.001).Conclusion ACAG has high efficacy in predicting HT after intravenous thrombolysis in stroke patients,outperforming other traditional indicators.A specific ACAG threshold(18.010 mmol/L)can be used clinically to effectively identify patients at high risk of hemorrhagic transformation.