PLR NLR水平与急性脑梗死患者神经功能缺损严重程度的关系

Relationship between PLR and NLR levels and the severity of neurological deficits in patients with acute cerebral infarction

目的探讨血小板与淋巴细胞比值(PLR)、中性粒细胞与淋巴细胞比值(NLR)水平与急性脑梗死(ACI)患者神经功能缺损严重程度的关系。方法纳入112例ACI患者及40名健康体检者,采用美国国立卫生院卒中量表(NIHSS)评分,评估ACI患者神经功能缺损严重程度;根据NIHSS评分将ACI患者分为3组:NIHSS≤6分为轻度组(78例),7~14分为中度组(20例),≥15分为重度组(14例)。根据脑梗死体积,将ACI患者分为小梗死灶组(81例),中梗死灶组(20例),大梗死灶组(11例)。根据血常规结果计算PLR、NLR。分析PLR、NLR与不同梗死体积及病情严重程度的关系。采用受试者工作特征曲线(ROC曲线)分析NLR、PLR水平对其神经功能缺损严重程度的预测价值。结果ACI组PLR、NLR水平均明显高于对照组(P<0.01);不同梗死体积组PLR、NLR水平比较,差异均有统计学意义(P<0.01);不同神经功能缺损程度组PLR、NLR水平,差异均有统计学意义(P<0.01)。Spearman相关分析显示,ACI患者超敏C反应蛋白(hs-CRP)与PLR、NLR呈正相关性(r=0.613,P<0.01;r=0.635,P<0.01);ROC曲线分析显示,PLR的曲线下面积(AUC)为0.810[95%CI(0.751,0.869),P<0.01],NLR的AUC值为0.882[95%CI(0.839,0.925)]。结论ACI患者PLR、NLR水平明显增高,与梗死体积及神经功能缺损严重程度密切相关,在一定程度上反映ACI患者病情的严重程度。

Objective To investigate the relationship between platelet-to-lymphocyte ratio(PLR),neutrophil-to-lymphocyte ratio(NLR)and the severity of neurological deficits in patients with acute cerebral infarction(ACI).Methods A total of 112 patients with ACI and 40 healthy subjects were enrolled.The NIHSS score was used to assess the severity of neurological deficits in patients with ACI.According to the NIHSS score,ACI patients were divided into three groups:NIHSS≤6 in mild group(n=78),7 to 14 in moderate group(n=20),NIHSS≥15 in severe group(n=14).According to the volume of cerebral infarction,ACI patients were divided into small infarct group(n=81),middle infarct group(n=20),and large infarct group(n=11).PLR and NLR were calculated by blood routine results.The relationship between PLR,NLR levels and different infarct size and severity of the relationship was analyzed.ROC curve was used to analyze the predictive value of NLR and PLR on the severity of neurological deficits.Results The levels of PLR and NLR in ACI group were significantly higher than those in control group(P<0.01).The levels of PLR and NLR in different infarct volume groups were significantly different(P<0.01).The levels of PLR and NLR in different degrees of neurological deficit group were significantly different(P<0.01).Spearman correlation analysis showed that there was a significant positive correlation between hs-CRP and PLR and NLR(r=0.613,P<0.01;r=0.635,P<0.01).ROC curve analysis showed that the area under the curve(AUC)of PLR was 0.810[95%CI(0.751,0.869),P<0.01],and the AUC of NLR was 0.882[95%CI(0.839,0.925)].Conclusions The levels of PLR and NLR in ACI patients were significantly increased,which were closely related to the infarct volume and the severity of neurological deficits,and to a certain extent,reflected the severity of acute cerebral infarction.