目的：探讨发病时年龄、入院时美国国立卫生研究院卒中量表（NIHSS）评分及 C 反应蛋白/白蛋白 （C-reactive protein to albumin ratio，CAR）对60岁以上急性脑梗死患者短期预后的影响。方法：本研究采用 回顾性队列研究。纳入2021年1月至2021年12月首都医科大学附属北京友谊医院神经内科收治的符合纳 排标准的60岁以上急性脑梗死患者作为研究对象，收集人口统计学资料、危险因素、入院时美国国立卫生研 究院卒中量表（National Institutes of Health stroke scale，NIHSS）评分、脑梗死病因、血液学指标、生化指标，计 算CAR；采用出院时的改良Rankin量表（modified Rankin Scale，mRS）评分评估患者预后（mRS评分＞2表示 预后不良，评分≤2分表示预后良好）。采用Logistic回归分析患者预后的影响因素，通过受试者工作特征曲 线（ROC）评价年龄、入院时基线NIHSS评分及CAR对60岁以上急性脑梗死患者短期预后的影响。结果：共 纳入符合标准的患者276例，其中短期预后不良94例（预后不良组），短期预后良好182例（预后良好组）。 Logistic回归分析及相关分析发现，入院时年龄（OR 1.080，95%CI 1.031-1.132，P=0.001），入院时NIHSS评分 （OR 1.768，95%CI 1.494-2.092，P=0.000），CAR（OR 4.294，95%CI 1.747-10.558，P=0.001）与60岁以上脑梗死 患者的短期预后正相关。ROC曲线分析结果显示，入院时NIHSS评分联合CAR评估60岁以上急性脑梗死 患者短期预后较单独使用入院时基线NIHSS或CAR有更高的准确性。结论：发病时年龄、入院时NIHSS评 分、CAR与60岁以上急性脑梗死患者出院时短期预后正相关。发病时基线NIHSS评分联合CAR评估60岁 以上急性脑梗死患者短期预后有较高的准确性。

To investigate the impact of age at onset, National Institutes of Health Stroke Scale (NIHSS) score at admission, and the C-reactive protein to albumin ratio (CAR) on the short-term prognosis of patients with acute cerebral infarction (ACI) aged over 60 years. Methods: This study employed a retrospective cohort design. Patients with ACI aged over 60 who were admitted to the Department of Neurology at Beijing Friendship Hospital, Capital Medical University, between January 2021 and December 2021 and met the inclusion and exclusion criteria were enrolled. Demographic data, risk factors, admission National Institutes of Health stroke scale (NIHSS) scores, etiology of cerebral infarction, and hematological and biochemical indicators were collected, and the CAR was calculated. Prognosis was assessed using the modified Rankin Scale (mRS) score at discharge (mRS score >2 indicated poor prognosis, while a score ≤2 indicated good prognosis). Logistic regression analysis was used to identify the influencing factors of patient prognosis. The receiver operating characteristic (ROC) curve was used to evaluate the predictive value of age, baseline NIHSS score at admission, and CAR for the short-term prognosis of ACI patients aged over 60. Results: A total of 276 eligible patients were included, comprising 94 with poor short-term prognosis (poor prognosis group) and 182 with good short-term prognosis (good prognosis group). Logistic regression and correlation analyses revealed that age at admission (OR 1.080, 95% CI 1.031-1.132, P=0.001), admission NIHSS score (OR 1.768, 95% CI 1.494-2.092, P<0.001), and CAR (OR 4.294, 95%CI1.747-10.558, P=0.001) were positively correlated with the short-term prognosis of ACI patients aged over 60. ROC curve analysis demonstrated that the combination of admission NIHSS score and CAR provided higher accuracy in evaluating the short-term prognosis of ACI patients aged over 60 compared to using baseline NIHSS or CAR alone. Conclusion: Age at onset, admission NIHSS score, and CAR are positively correlated with the short-term prognosis at discharge in ACI patients aged over 60. The combination of baseline NIHSS score and CAR demonstrates high accuracy in assessing the short-term prognosis of these patients.