中性粒细胞/淋巴细胞值及血小板/淋巴细胞值与急性缺血性脑梗死预后的关系

Relationship between neutrophil/lymphocyte ratio,platelet/lymphocyte ratio and the prognosis in patients with acute ischemic stroke

目的:探讨发病时血常规检查中性粒细胞/淋巴细胞值及血小板/淋巴细胞值与急性缺血性脑梗死预后的关系。方法:对在我院治疗的113例急性缺血性脑梗死患者血常规中性粒细胞/淋巴细胞值和血小板/淋巴细胞值与患者出院后第90天的改良Rankin评分之间的关系进行分析。结果:出院后第90天时,113例中改良Rankin评分为0~2分的患者(预后良好组)为54例,评分为3~6分的患者(预后不良组)为59例。与预后不良组相比,预后良好组的中性粒细胞/淋巴细胞值及血小板/淋巴细胞值偏小(均P<0.001)。受试者工作特征(ROC)曲线分析显示:中性粒细胞/淋巴细胞值预测急性缺血性脑梗死预后的曲线下面积为0.888(95%CI:0.815~0.940),取截点值为3.26,此时预测的敏感性为81.48%,特异性为83.05%;血小板/淋巴细胞值预测急性缺血性脑梗死预后的ROC曲线下面积为0.788(95%CI:0.702~0.860),取截点值为140.71,此时预测的敏感性为92.59%,特异性为50.85%。二元Logistic回归分析显示,中性粒细胞/淋巴细胞值、血小板/淋巴细胞值均是急性缺血性脑梗死患者预后不良的独立预测因子。结论:中性粒细胞/淋巴细胞和血小板/淋巴细胞值可用于急性缺血性脑梗死患者预后的评估。

Objective： To investigate the relationship between neutrophil/lymphocyte ratio （NLR）, platelet/ lymphocyte ratio（PLR） and the prognosis in patients with acute ischemic stroke （AIS）. Methods： A restropective review was performed on 113 AIS patients in our hospital. Routine blood tests at the onset time were analyzed, the NLR and PLR were obtained. The relationship between these markers and modified Rankin scale （mRS） of the patients on the ninetieth day after discharged were analyzed. Results： There were 54 patients with mRS from 0 to 2 （satisfactory prognosis group） and 59 patients with mRS from 3 to 6 （unsatisfactory prognosis group ） on the ninetieth day after discharged. Compared with unsatisfactory prognosis group, NLR and PLR value in satisfactory prognosis group were smaller （all P 〈 0. 001 ）. Receiver operation characteristic （ROC） curve analysis showed that the area under the curve of using NLR to predict the prognosis of AIS was 0. 888（95% CI：O. 815 ~0. 940） , the sensitivity was 81.48% and the specificity was 83.05% with the cut-off value of 3.26. Area under the ROC curve of using PLR to prediet the prognosis of A1S was 0. 788 （95% CI：O. 702 - 0. 860）, the sensitivity was 92.59% and the specificity was 50.85% with the eut-off value of 140.71. Logistie regression analysis revealed that NLR and PLR remained independent predietors for the prognosis of AIS. Conclusion ： NLR and PLR at onset time are strong and independent predictors of the prognosis in patients with AIS.