WMR对大动脉粥样硬化性卒中患者短期转归的影响及预测价值分析

Effects of WMR on short-term outcomes and its predictive value in patients with large-artery atherosclerotic stroke

目的分析白细胞计数/平均血小板体积(white blood cell count to mean platelet volume ratio,WMR)值对大动脉粥样硬化性卒中患者短期转归的影响及预测价值,以期为该病提供诊断及治疗方向。方法选择2015年5月—2018年7月在诸暨市人民医院就诊的120例大动脉粥样硬化性卒中患者为研究对象,根据短期转归情况将其分为转归良好组(65例)和转归不良组(55例)。收集所有患者的人口统计学特征、血管危险因素、基线血压、基线美国国立卫生研究院卒中量表(NIH stroke scale,NIHSS)评分及实验室检查指标水平。采用二元logistic回归分析分析影响因素,绘制受试者工作特征(receiver operating characteristic,ROC)曲线,采用曲线下面积(area under curve,AUC)评价WMR对大动脉粥样硬化性卒中的预测价值。结果收缩压、基线NIHSS评分和WMR是大动脉粥样硬化性卒中短期转归不良的独立危险因素(均P<0.05);转归良好组的WMR比值为0.86±0.32,转归不良组为1.01±0.25,WMR预测患者短期转归的AUC值为0.826。结论收缩压、基线NIHSS评分和WMR是大动脉粥样硬化性卒中患者短期转归不良的独立危险因素,WMR在此类患者的短期转归中具有较好的预测价值。

Objective To analyze the effects of white blood cell count to mean platelet volume ratio(WMR)on short-term outcomes and its predictive value in patients with large-artery atherosclerotic stroke,so as to provide the direction for diagnosis and treatment of the disease.Methods A total of 120 patients with large-artery atherosclerotic stroke who were admitted to Zhuji People’s Hospital from May 2015 to July 2018 were selected and were divided into good prognosis group(n=65)and poor prognosis group(n=55)according to the short-term outcome of patients.The demographic characteristics,vascular risk factors,baseline blood pressure,the baseline NIH Stroke Scale(NIHSS)scores and laboratory examination indexes levels of all patients were collected.The influencing factors were analyzed by binary logistic regression,and the receiver operating characteristic(ROC)curve was drawn.The area under the ROC curve(AUC)was used to evaluate the predictive value of WMR for large-artery atherosclerotic stroke.Results Systolic blood pressure,baseline NIHSS score and WMR level were independent risk factors for poor short-term outcomes of large-artery atherosclerotic stroke(all P<0.05);The WMR ratio of the good prognosis group was 0.86±0.32,and that of the poor prognosis group was 1.01±0.25,The AUC value of WMR in predicting short-term outcomes of patients was 0.826.Conclusion Systolic blood pressure,baseline NIHSS score and WMR are the independent risk factors for poor short-term outcomes of patients with large-artery atherosclerotic stroke.WMR has a good predictive value in short-term outcomes of these patients.