血小板淋巴细胞比值与取栓治疗的脑梗死患者预后的关系

Relationship between platelet-to-lymphocyte ratio and clinical outcome in patients having undergone thrombectomy for acute ischemic stroke

目的探讨血小板淋巴细胞比值(PLR)与经过机械取栓治疗的前循环大血管闭塞导致的脑梗死患者预后的关系。方法回顾性分析2018年1月至12月期间在青岛市中心医院神经内科行前循环机械取栓的急性脑梗死合并大血管闭塞患者92例,依据受试者工作特征(ROC)曲线的截断点将患者分为2组:PLR>168组(n=48)和PLR≤168组(n=44)。比较2组患者术后血管再通成功率,术后30、90 d的改良Rankin量表(mRS)评分等临床指标。采用SPSS 19.0软件进行数据处理。ROC曲线评估PLR与预后的相关性。结果PLR≤168组患者术后血管再通率显著高于PLR>168组(90.9%和70.8%,P=0.011)。术后30 d,PLR≤168组中mRS≤2分者显著多于PLR>168组(54.5%和18.8%,P=0.001)。术后90 d,PLR≤168组中mRS≤2分者显著多于PLR>168组(56.5%和22.9%,P=0.001),死亡率显著低于PLR>168组(9.1%和27.1%,P=0.026)。PLR预测行前循环机械取栓的急性脑梗死合并大血管闭塞患者预后的截断点为168,灵敏度为68%,特异度为67%,ROC曲线下面积为0.738。结论较高的PLR与经过机械取栓治疗的前循环脑血管闭塞导致的脑梗死患者的不良预后相关。

Objective To investigate the relationship between the platelet-to-lymphocyte ratio(PLR)and prognosis of the patients who underwent thrombectomy for acute anterior circulation ischemic stroke.Methods A retrospective analysis was made of demographic data of 92 patients having undergone thrombectomy for acute anterior circulation ischemic stroke.On the basis of a PLR level cut-off value of 168 from receiver operating characteristic(ROC)curve,the patients were divided into two groups:PLR>168 group(n=48)and PLR≤168 group(n=44).The two groups were compared in clinical indices including success rate of postoperative revascularization and modified Rankin scale(mRS)scores at postoperative 30 and 90 days.Data was processed using SPSS statistics 19.0.ROC curve was used to assess the correlation between PLR and prognosis.Results Successful revascularization were 70.8%in the PLR>168 group against 90.9%in the PLR≤168 group(P=0.011).At postoperative 30 days,patients with mRS≤2 were significantly more in the PLR≤168 group(54.5%)than in the PLR>168 group(18.8%,P=0.001).Compared with the PLR>168 group at postoperative 90 days,the PLR≤168 group had significantly more patients with mRS≤2(56.5%vs 22.9%,P=0.001)and significantly lower mortality rate(27.1%vs 9.1%,P=0.026).The PLR value predicted a cut-off point of 168 with a sensitivity of 68%,a specificity of 67%,and the area under the ROC curve of 0.738 for the prognosis of patients having undergone pre-circumferential mechanical thrombectomy for acute cerebral infarction complicated with large vascular occlusion.Conclusion High PLR is associated with the poor prognosis of the patients having undergone mechanical thrombectomy for with cerebral infarction caused by anterior circulation cerebral vascular occlusion.