血白细胞计数与急性缺血性脑卒中患者短期预后的关系

Relationship between leukocyte count and short-term outcome in patients with acute ischemic stroke

目的探讨血白细胞计数与急性缺血性脑卒中患者短期预后的关系。方法收集3151例急性缺血性脑卒中的一般资料,并进行血常规、生化指标及凝血四项的测定和改良Rankin量表(mRS)评分。采用Logistic回归分析血白细胞计数与急性缺血性脑卒中短期不良预后的关系。结果根据mRS评分,将患者分为无残疾组2640例,残疾组407例,死亡组104例;511例为短期不良结局。残疾组的高血糖史、脑卒中复发、血脂异常比率及体温、血糖、纤维蛋白原、白细胞计数显著高于无残疾组(均P<0.05)。死亡组的高血糖史、脑卒中复发、血脂异常的比率及年龄、体温、血糖、低密度脂蛋白胆固醇、肌酐、尿素氮、纤维蛋白原、白细胞计数显著高于无残疾组(均P<0.05)。单因素Logistic回归分析显示,年龄、脑卒中复发、体温升高、高血糖、血脂异常、纤维蛋白原升高、尿素氮升高与白细胞计数升高是发生短期不良结局的危险因素(均P<0.01)。多因素Logistic回归分析显示,白细胞计数为10.1×109/L^11.0×109/L、11.1×109/L^12.0×109/L、≥12.1×109/L是急性缺血性脑卒患者发生短期预后不良的独立危险因素(P<0.05~0.01),并且发生短期预后不良的风险随着白细胞计数的增高而增加(趋势性P<0.01)。结论急性缺血性脑卒中患者入院时血白细胞计数升高增加了短期预后不良发生的风险。

Objective To explore the relationship between leukocyte count and the short-term outcome in patients with acute ischemic stroke. Methods General data of 3151 ischemic stroke patients were collected. Blood routine examination, biochemical indexes and blood coagulation test were introduced, and modified Rankin scale （mRS） were evaluated. Logistic regression was performed to assess the relationship between leukocyte count and short-term outcome. Results According to mRS, patients were divided into non-disability group （2640 cases ）, disability group （407 cases） and death group （104 cases） ; 511 patients had poor short-term outcome. The rates of hyperglycemia, stroke recurrence, lipid abnormality and body temperature, blood glucose, fibrinogen and leukocyte count in disability group were significantly increased compared to those in non-disability group （ all P 〈 0. 05 ）. The rates of hyperglycemia, stroke recurrence, lipid abnormality age, temperatune, blood glucose, low density lipoprotein cholesterol, creatinine, urea nitrogen, fibrinogen and leukocyte count in death group were significantly higher than those in non-disability group （ all P 〈 0. 05 ）. Univariate logistic regression showed that age, stroke recurrence, feverscence, hyperglycemia, hyperlipidemia, high fibrinogen, high urea nitrogen and leukocyte count increasing were risk factors of poor short-term outcome （ all P 〈 0.01 ）. Multiple logistic regression analysis showed leukocyte count in the range of 10.1 × 109/L - 11.0 × 109/L, 11.1 ×109/L - 12.0 × 109/L, ≥ 12.1 × 109/L were independent risk factors of poor short-term outcome in patients with acute ischemic stroke （P 〈 0. 05 -0.01 ）. The risk of poor shortterm outcome was increased with increasing leukocyte count （trend P 〈 0. 01 ）. Conclusion Higher leukocyte increases the risk of poor short-term outcome in patients with acute ischemic stroke.