早期中性粒细胞与淋巴细胞比值对急性脑梗死面积的预测价值

Value of early neutrophil/lymphocyte ratio in predicting acute ischemic stroke volume

目的探讨外周血早期中性粒细胞/淋巴细胞比值(neutrophil to lymphocyte ratio,NLR)对急性脑梗死面积的预测价值。方法回顾性分析24h内入院的首次发作前循环脑梗死患者113例,根据头颅CT或MRI的脑梗死面积大小将患者分为腔隙性脑梗死组42例、中等面积脑梗死组40例和大面积脑梗死组31例。记录患者年龄、性别、既往史等一般临床资料以及发病24h内的血常规结果,计算NLR并进行统计学分析。结果 3组在年龄、糖尿病、白细胞计数、中性粒细胞绝对值、淋巴细胞绝对值、NLR和血红蛋白等方面比较,差异有统计学意义(P<0.05,P<0.01)。白细胞计数、中性粒细胞绝对值、NLR和淋巴细胞绝对值对大面积脑梗死预测的曲线下面积分别为0.669、0.740、0.802和0.744,其中NLR、中性粒细胞绝对值的曲线下面积与白细胞计数比较,差异有统计学意义(P<0.05)。NLR预测大面积脑梗死最佳界值为3.940,预测大面积脑梗死的敏感性和特异性分别为80.6%和78.0%。结论外周血早期NLR对大面积脑梗死有一定的预测价值。

Objective To study the value of early neutrophil/lymphocyte ratio （NLR） in predicitng the acute ischemic stroke （AIS） volume. Methods One hundred and thirteen AIS patients admit- ted to our hospital from November 2012 to November 2014 were divided into lacunar AIS group （n=42） ,median AIS group （n=40） ,large AIS group （n=31） according to their CT or MRI. Gen- eral clinical data such as age,sex,past history and blood routine test within 24 h after onset of the disease were recorded. The NLR was calculated and analyzed. Results The age,incidence of dia- betes, number of WBC, neutrophils and lymphocytes, NLR and hemoglobin level were significant- ly different in 3 groups （P〈0.05,P〈0.01）. The area under the curve of WBC,absolute neutro- phils and lymphocytes, NLR for predicting large ischemic stroke was 0. 669,0. 740,0. 802 and 0. 744,respectively. The area under the curve of NLR was significantly different from that of WBC （P〈0.05）. The optimal cut-off value of NLR was 3. 940,with a sensitivity of 80.6% and a specficity of 78.0% for predicting large ischemic stroke. Conclusion Early peripheral NLR plays a role in predicting AIS volume.