中性粒细胞与淋巴细胞比值对急性脑梗死患者预后的预测价值

发布时间：2018-05-22 08:06

本文选题：急性脑梗死 + 淋巴细胞　；参考：《中国脑血管病杂志》2017年02期

【摘要】：目的探讨中性粒细胞与淋巴细胞比值(NLR)对急性脑梗死患者预后的预测价值。方法回顾性连续纳入2014年1月至2015年12月郑州大学第五附属医院神经内科住院的急性脑梗死患者307例,其中女80例,男227例。根据改良Rankin量表评分标准,分为预后良好组(195例)和预后不良组(112例)。记录入院时年龄、性别、既往病史、美国国立卫生研究院卒中量表(NIHSS)评分等资料,根据入院中性粒细胞计数与淋巴细胞计数计算出NLR值。采用Logistics回归分析急性脑梗死预后不良的影响因素,采用受试者工作特征(ROC)曲线评价入院时NLR水平对急性脑梗死患者预后不良的预测作用。结果 (1)与预后良好组比较,预后不良组患者年龄、复发性脑梗死发生率、入院时NIHSS评分、入院NLR水平均较高,组间差异均有统计学意义[(69±12)岁比(62±14)岁,25.0%(28/112)比14.4%(28/195),5.00(3.00,9.00)分比3.00(1.75,5.00)分,3.66(2.62,7.91)比2.47(1.94,3.40),均P0.05],其余基线资料和临床特征的组间差异均无统计学意义(均P0.05)。(2)多因素Logistics回归分析结果显示,年龄、入院NIHSS评分及入院时NLR水平的升高,是预后不良的独立危险因素(OR值分别为1.030,1.148,1.427,95%CI分别为1.007~1.053,1.059~1.246,1.247~1.634,均P0.05)。(3)入院时NLR水平对急性脑梗死患者预后不良的诊断界值为2.84,其敏感度为69.6%,特异度为64.6%。结论入院时NLR水平增高对评估急性脑梗死患者预后不良具有一定的参考价值。
[Abstract]:Objective to investigate the prognostic value of neutrophil / lymphocyte ratio (NLR) in patients with acute cerebral infarction. Methods 307 patients with acute cerebral infarction admitted to the Department of Neurology, Fifth affiliated Hospital of Zhengzhou University from January 2014 to December 2015, including 80 women and 227 men. According to the modified Rankin scale, the patients were divided into good prognosis group (195 cases) and poor prognosis group (112 cases). Age, sex, past medical history and NIHSS score were recorded at admission. The NLR values were calculated according to the neutrophil count and lymphocyte count. Logistics regression analysis was used to evaluate the prognostic factors of acute cerebral infarction (ACI) and the predictive effect of NLR level on the prognosis of patients with acute cerebral infarction (ACI) was evaluated by using the operating characteristics of the subjects. Results compared with the good prognosis group, the patients with poor prognosis had higher age, recurrent cerebral infarction rate, NIHSS score at admission and NLR level at admission. There were significant differences between the two groups [69 卤12 years old vs 62 卤14 years old: 28% 11: 12) vs 14.44% 28 / 195 5.003.00 / 9.00) scores compared with 3.00 1.755.00 scores (3.66 卤2.627.91) vs 2.471.94nd3.40g (P0.05). There was no significant difference between the other baseline data and the clinical features (all P0.05.2.0. 2). The results of Logistics regression analysis showed that there were no significant differences between the other baseline data and the clinical features (all P0.05. 2), and the results of Logistics regression analysis showed that there was no significant difference between the two groups in terms of age, and clinical characteristics (P > 0.05), and the results of Logistics regression analysis showed that there were no significant differences between the two groups (P < 0.05). The NIHSS score and the increase of NLR level on admission were independent risk factors for poor prognosis. The OR values were 1.030 / 1.148 / 1.427795 / 95 CI = 1.007 / 1.053 / 1.0591.2461.247/ 1.634, respectively. The threshold value of NLR level for the poor prognosis of patients with acute cerebral infarction was 2.84, the sensitivity was 69.6and the specificity was 64.6. Conclusion the increase of NLR level at admission has some reference value in evaluating the poor prognosis of patients with acute cerebral infarction.
【作者单位】：郑州大学第五附属医院神经内科;
【基金】：国家自然科学基金资助项目(81571137) 河南省科技创新领军人才(52110052)
【分类号】：R743.33

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