脑梗死和短暂性脑缺血患者外周血RDW与NLR变化及相关性研究

Analysis of Relationship between RDW and Inflammation Index in Patients with Cerebral Infarction

目的探讨脑梗死和短暂性脑缺血发作患者外周血红细胞分布宽度(RDW)、中性粒细胞与淋巴细胞比值(NLR)的变化及之间的相关性。方法选取华北理工大学附属医院神经内科2010年5月～2016年7月收治的630例首发的急性脑梗死患者作为脑梗死组,162例首发的短暂性脑缺血发作患者作为短暂性脑缺血发作组,即TIA组,另选取150例健康体检者为对照组,比较各组患者外周血RDW,NLR,白细胞计数,血液流变学相关指标的水平,分析各组患者RDW与NLR之间的相关性。结果①急性脑梗死组水平高于TIA组及对照组[刚性指数4.18±0.49 vs 3.89±0.51和3.74±0.40,红细胞聚集指数4.91±0.59 vs 4.69±0.61和4.12±0.54,NLR 2.38±1.19 vs 2.01±1.00和1.36±0.85,白细胞计数(7.23±1.06 vs 6.42±0.79和5.12±0.82)×10~9/L,RDW 13.44%±0.59%vs 12.73%±0.58%和11.64%±0.51%],变形指数低于TIA组及对照组[0.66±0.05 vs 0.73±0.05和0.77±0.06],差异均有统计学意义(F=8.952～129.849,49.258,均P<0.001);②TIA组RDW,红细胞聚集指数,白细胞计数及NLR水平均高于对照组,差异均有统计学意义(P<0.001);③脑梗死组和TIA组中RDW与NLR呈正相关(r=0.73,P<0.01;r=0.63,P<0.01),但对照组RDW与NLR不相关(r=0.21,P=0.149)。结论脑梗死和短暂性脑缺血发作患者外周血RDW与NLR呈正相关,RDW可以为脑梗死和短暂性脑缺血发作患者的炎症状态起到提示作用。

Objective To investigate the relationship among red blood cell distribution width(RDW),peripheral leukocyte count and neutrophil/lymphocyte ratio(NLR)in patients with cerebral infarction and transient ischemic attack,especially the correlation between RDW and NLR,and analyze whether RDW can play a role in indicating the inflammation of cerebral infarction.Methods 630patients with first-episode acute cerebral infarction were selected as the cerebral infarction group,162patients with first-episode transient ischemic attack as the transient ischemic attack group(TIA group)and 150healthy persons as the control group.Peripheral blood RDW,NLR,white blood cell count and water of Hemorheology related indicators in each group were compared.Meanwhile,the correlation between RDW and NLR in each group was analyzed.Results①The level of RBC rigidity index(4.18±0.49vs 3.89±0.51,3.74±0.40),RBC aggregation index(4.91±0.59vs 4.69±0.61,4.12±0.54),NLR(2.38±1.19vs 2.01±1.00,1.36±0.85),WBC(7.23±1.06vs 6.42±0.79,5.12±0.82)×109/L and RDW(13.44%±0.59%vs 12.73%±0.58%,11.64%±0.51%)in acute cerebral infarction group were higher than that of TIA group,and control group and the deformation deformability index(0.66±0.05vs 0.73±0.05,0.77±0.06)were lower than TIA group and control group(F=8.952~129.849,49.258,P<0.001).②The level of RDW RBC aggregation index,WBC and NLR in the TIA group were higher than control group.There was a significant difference in the control group(P<0.001).③RDW was positively correlated with NLR in cerebral infarction group and TIA group(r=0.73,P<0.01;r=0.63,P<0.01),but RDW was not correlated with NLR in control group(r=0.21,P=0.149).Conclusion The correlation between the RDW and NLR was positive in patients with the cerebral infarction or the TIA,which meant RDW can be a warning for the inflammation of cerebral infarction and the TIA.