中性粒细胞比率、血糖水平与急性脑梗死患者短期预后的关系

Neutrophil ratio/blood glucose and poor short outcome among patients with acute ischemic stroke

目的 探讨急性脑梗死患者入院时中性粒细胞比率、血糖水平与其短期预后的关系.方法 以山东省4家医院的2 265例急性脑梗死住院患者为研究对象,通过查阅病历档案,收集患者入院时的人口统计学资料、生活方式、疾病史、家族史及实验室资料等.研究终点事件定义为患者出院评分NIHSS≥5或住院期间死亡.将研究对象分为4组：中性粒细胞比率、血糖均正常组（NN/NG）;中性粒细胞比率正常、血糖高组（NN/IG）;中性粒细胞比率高、血糖正常组（IN/NG）;中性粒细胞比率、血糖均高组（IN/IG）.采用非条件logistic回归分析中性粒细胞比率、血糖与急性脑梗死短期预后的关系.结果 急性脑梗死患者终点事件发生组的中性粒细胞比率和血糖高于未发生组,差异有统计学意义（均P＜0.05）.经多因素调整后,与NN/NG相比,NN/IG、IN/NG和IN/IG组发生终点事件的OR值（95％CI）分别为1.356 （0.942 ～ 1.953）、1.879（1.113～3.171）和2.210（1.477～3.307）.结论 急性脑梗死患者人院时中性粒细胞比率是其短期预后不良的独立危险因素.IN/IG发生短期预后不良的危险最大.中性粒细胞比率/血糖水平可作为急性脑梗死短期预后不良的预测指标.

Objective To investigate the relationship between neutrophil ratio/blood glucose and short outcome among patients with acute ischemic stroke admitted to hospitals.Methods A total of 2 265 acute ischemic stroke patients in four hospitals in Shandong province were included in this study.Through access to patients＇ files,data on demographic,lifestyle,medical history,family history and laboratory findings were collected from all participants at admission.Endpoint of the study was defined as poor short-term prognosis of acute cerebral infarction （NIHSS≥5） at discharge or death during hospitalization.Subjects of this study were divided into four groups：normal neutrophil ratio with normal blood glucose （NN/NG） ;normal neutrophil ratio with high blood glucose （NN/IG） ;high neutrophil ratio with normal blood glucose （IN/NG） and high neutrophil ratio with high blood glucose （IN/IG）.Non-conditional logistic regression analysis was used to evaluate the association between blood glucose/neutrophil ratio and the short outcome of acute ischemic stroke.Results Neutrophil ratio and the level of blood glucose in patients with study endpoints were both higher than those without the study endpoints,and the difference was statistically significant （all P＜0.05）. After multivariate adjustment,when compared to NN/NG group,the ORs （95％ CI） of NN/IG,IN/NG and IN/IG group were 1.356 （0.942-1.953）,1.879 （1.113-3.171） and 2.210 （1.477-3.307）,respectively.Conclusion Neutrophil ratio at admission was an independent risk factor of poor short outcome in patients with acute ischemic stroke.IN/IG group was considered at a highest risk in general population.Neutrophil ratio/glucose was valuable in predicting the incidence of poor short outcome in acute ischemic stroke patients.