HALP指数预测老年缺血性脑卒中病人衰弱风险的价值

doi:10.3969/j.issn.1003-9198.2026.02.008

摘要/Abstract

摘要： 目的探究血红蛋白-白蛋白-淋巴细胞-血小板(hemoglobin-albumin-lymphocyte-platelet,HALP)指数预测老年缺血性脑卒中病人并发衰弱的价值。方法选择2019—2024年合肥市第二人民医院全科医学科就诊的老年缺血性脑卒中病人257例,收集病人基线资料并计算HALP指数。随访观察90 d,采用Tilburg衰弱量表(Tilburg Frailty Indicator,TFI)评估病人的衰弱状态,采用改良Rankin评分量表(Modified Rankin Scale,mRS)评估病人的神经功能恢复状态。采用单因素及多因素logistic回归分析HALP指数与老年缺血性脑卒中病人并发衰弱(TFI≥5分)及预后不佳(mRS≥3分)的相关性。绘制ROC曲线,分析HALP指数预测老年缺血性脑卒中病人衰弱风险的价值。结果随访90 d,119例病人(46.3%)发生衰弱,130例病人(50.6%)预后不佳。ROC曲线分析结果显示,以HALP指数<44.5作为预测老年缺血性卒中病人并发衰弱的截断值,其敏感度为87.8%,特异度为81.5%(AUC=0.869,P<0.001)。单因素logistic回归分析显示,营养不良、血小板计数、NIHSS评分、白蛋白、血红蛋白、淋巴细胞计数及HALP指数与老年缺血性脑卒中病人并发衰弱相关,男性、血小板计数、C-反应蛋白、NIHSS评分、HALP指数与老年缺血性脑卒中病人预后不佳相关。进一步的多因素logistic回归分析显示,即便在校正了混杂因素后,低HALP指数(<44.5)仍然是老年缺血性脑卒中病人并发衰弱(校正OR=25.08,95%CI:10.39~60.53,P<0.001)和预后不佳(校正OR=2.39,95%CI:1.37~4.19,P=0.002)的独立危险因素。结论 HALP指数<44.5与老年缺血性脑卒中病人并发衰弱和预后不佳密切相关,有望作为预测老年缺血性脑卒中病人衰弱发生的潜在生物学标志物。

关键词: 缺血性脑卒中, 老年人, 衰弱, HALP指数, 预后不良

Abstract: Objective To explore the predictive effects of hemoglobin-albumin-lymphocyte-platelet (HALP) score on the onset of frailty in the elderly patients with ischemic stroke. Methods A total of 257 elderly patients with ischemic stroke were enrolled from Department of General Practice, Hefei Second People’s Hospital from January 2019 to December 2024. The baseline characteristics were collected and HALP score was calculated. After 90 days of follow-up, Tilburg Frailty Indicator (TFI) was applied to evaluate the status of frailty, and Modified Rankin Scale (mRS) was applied to evaluate the recovery of neurological function of the patients. Univariate and multivariate logistic regression analyses were used to assess the association between HALP score and frailty onset (TFI≥5) and poor prognosis (mRS≥3) in the elderly patients with ischemic stroke. Receiver operating characteristic (ROC) curve was drawn to analyze the predictive effects of HALP score on the onset of frailty in the elderly patients with ischemic stroke. Results Ninety days after follow-up, there were 119 patients (43.6%) suffering from frailty and 130 patients (50.6%) had poor prognosis. ROC curve analysis showed that the optimal cut-off value of HALP score predicting frailty was 44.5 with a sensitivity of 87.8% and a specificity of 81.5% (the area under ROC curve was 0.869, P<0.001). Univariate regression analysis showed that malnutrition, platelet count, National Institute of Health Stroke Scale (NIHSS) score, albumin level, hemoglobin level, lymphocyte count, and HALP score were risk factors of frailty in the elderly patients with ischemic stroke; while male, platelet count, C-reactive protein, NIHSS score, and HALP score were risk factors of poor prognosis in the elderly patients with ischemic stroke. Further multiple logistic regression analysis demonstrated that after adjusting for these confounders, low HALP score (<44.5) remained a significant risk factor for frailty (adjusted OR=25.08, 95%CI:10.39-60.53, P<0.001) and for poor prognosis (adjusted OR=2.39, 95%CI:1.37-4.19, P=0.002) in the elderly patients with ischemic stroke. Conclusions Low HALP score (<44.5) is associated with the risk of frailty and poor prognosis in the elderly patients with ischemic stroke. HALP score might serve as a novel potential biomarker for the prediction of frailty onset in the elderly patients with ischemic stroke.

Key words: ischemic stroke, aged, frailty, HALP score, poor prognosis

中图分类号:

R 743.3

王昆, 谢军. HALP指数预测老年缺血性脑卒中病人衰弱风险的价值[J]. 实用老年医学, 2026, 40(2): 142-146.

WANG Kun, XIE Jun. Predictive value of HALP score on the onset of frailty in the elderly patients with ischemic stroke[J]. Practical Geriatrics, 2026, 40(2): 142-146.

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