目的 分析溶栓前中性粒细胞与淋巴细胞比值(neutrophil to lymphocyte ratio,NLR)、淋巴细胞与单核细胞比值(lymphocyte to monocyte ratio,LMR)对急性缺血性脑卒中(acute ischemic stroke,AIS)溶栓患者临床预后的预测价值.方法 回顾性分析2023年1月至6月内蒙古自治区人民医院收治的196例静脉溶栓AIS患者的临床资料,根据溶栓后90d改良Rankin量表(modified Rankin scale,mRS)评分将患者分为改善组(mRS评分≤2分)和未改善组(mRS评分＞2分).收集患者的临床资料,采用二元Logistic回归分析探讨影响患者预后的独立影响因素,绘制受试者操作特征曲线分析NLR、LMR的预测价值.结果 改善组患者的年龄、糖尿病病史占比、抗血小板用药史占比均显著小于未改善组(P＜0.05),改善组患者的D-二聚体、中性粒细胞绝对值、C反应蛋白、NLR均显著低于未改善组,淋巴细胞绝对值、LMR均显著高于未改善组(P＜0.05).二元Logistic回归分析结果显示,NLR升高、糖尿病病史、抗血小板用药史均是影响AIS患者预后的独立危险因素(P＜0.05).NLR、糖尿病病史、抗血小板用药史预测AIS患者预后的曲线下面积(area under the curve,AUC)分别为0.682、0.616、0.563,三项联合预测的AUC为0.742,敏感度为66.9％,特异性为75.0％.结论 NLR、糖尿病病史、抗血小板用药史对AIS患者的预后有一定预测价值.
Abstract
Objective To analyze the predictive value of neutrophil to lymphocyte ratio(NLR)and lymphocyte to monocyte ratio(LMR)before thrombolysis in patients with acute ischemic stroke(AIS)who received intravenous thrombolysis.Methods The clinical data of 196 AIS patients who received intravenous thrombolysis in Inner Mongolia Autonomous Region People's Hospital from January to June 2023 were analyzed retrospectively.According to the modified Rankin scale(mRS)score 90 days after thrombolysis,the patients were divided into improvement group(mRS score ≤2 points)and non-improvement group(mRS score＞2 points).The clinical data of patients were collected.Binary Logistic regression analysis was used to explore the independent factors affecting the prognosis of patients.Receiver operating characteristic curve was drawn to analyze the predictive value of NLR and LMR.Results The age,proportion of diabetes history and antiplatelet drug history in improvement group were significantly lower than those in non-improvement group(P＜0.05).The D-dimer,neutrophil absolute value,C-reactive protein and NLR in improvement group were significantly lower than those in non-improvement group,while lymphocyte absolute value and LMR in improvement group were significantly higher than those in non-improvement group(P＜0.05).Binary Logistic regression analysis showed that elevated NLR,diabetes history,and antiplatelet drug history were independent risk factors affecting the prognosis of AIS patients(P＜0.05).The area under the curve(AUC)of NLR,diabetes history,and antiplatelet drug history predicted the prognosis of AIS patients was 0.682,0.616,and 0.563,respectively.The AUC of combined prediction of these three indexes was 0.742,with a sensitivity of 66.9％and a specificity of 75.0％.Conclusion NLR,diabetes history,and antiplatelet drug history have predictive value for AIS patients.
关键词
急性缺血性脑卒中/中性粒细胞/淋巴细胞/单核细胞/静脉溶栓/预测价值
Key words
Acute ischemic stroke/Neutrophil/Lymphocyte/Monocyte/Intravenous thrombolysis/Predictive value
维普
万方数据