中性粒细胞和淋巴细胞比率与溶栓后急性脑卒中预后的关系

Neutrophil to lymphocyte ratio for the prognosis of acute ischemic stroke patients with intravenous thrombolysis

目的探讨中性粒细胞与淋巴细胞比率(neutrophil and lymphocyte ratio,NLR)与急性缺血性脑卒中的严重程度以及患者接受静脉溶栓治疗后临床预后的关系。方法回顾性研究2016年1月至2019年1月北京大学人民医院急诊科及重症监护室符合急性缺血性脑卒中(acute ischemic stroke,AIS)诊断标准的147例静脉溶栓患者,根据NLR值,将147例患者分为NLR≤2组(37例),2<NLR<3组(31例)及NLR≥3组(79例)。比较各组患者的一般资料、既往病史、实验室检查结果、NIHSS评分、mRS评分,采用Logistic回归分析NLR与急性缺血性脑卒中患者严重程度以及溶栓后临床预后的关系。结果NLR与AIS卒中严重程度相关(OR=2.044,95%CI:1.011~8.566,P=0.006)。NLR与溶栓后AIS神经功能预后不良相关(OR=3.744,95%CI:0.997~4.713,P=0.003)。然而,NLR与溶栓后AIS死亡无关(OR=0.591,95%CI:0.750~1.933,P=0.442)。结论NLR与AIS患者脑卒中的严重程度、溶栓后神经功能不良预后有关。

Objective To investigate the relationship between neutrophil to lymphocyte ratio(NLR)and the severity of acute ischemic stroke(AIS)and the prognosis of patients undergoing intravenous thrombolysis(IVT).Methods From January 2016 to January 2019,147 AIS patients with intravenous thrombolysis in the Emergency Department of Peking University People's Hospital who met the diagnostic criteria of AIS were studied retrospectively.According to the NLR value,147 patients were divided into the NLR 2 or less group(n=37)or less,2<NLR<3 group(n=31),and the NLR≥3 group(n=79).General data,medical history,laboratory examination results,NIHSS score and mRS score of patients in each group were compared.Logistic regression analysis was used to analyze the relationship between NLR and severity of acute ischemic stroke patients and clinical prognosis with thrombolysis.Results NLR was associated with AIS stroke severity(OR=2.044,95%CI:1.011-8.566,P=0.006).NLR was associated with poor prognosis of AIS neurological function with thrombolysis(OR=3.744,95%CI:0.997-4.713,P=0.003).However,NLR was not associated with AIS death after thrombolysis(OR=0.591,95%CI:0.750-1.933,P=0.442).Conclusions NLR was associated with the severity of stroke in AIS patients and the prognosis of poor neurological function with thrombolysis.