血小板相关指数与溶栓后急性脑卒中患者预后的关系

The relationship between platelet volume-related indices for the prognosis of acute ischemic stroke with intravenous thromblysis

目的 研究血小板体积相关指数(platelet volume indices, PVIs)、中性粒细胞/淋巴细胞比率(neutrophil to lymphocyte ratio,NLR)以及这些参数的组合与接受静脉溶栓后的急性缺血性脑卒中(acute ischemic stroke,AIS)患者神经功能预后的关系。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符合AIS诊断标准的147例静脉溶栓患者。根据3个月后随访结果,将研究人群依据MRS评分(modified rank in scale,MRS),分为MRS≤2和MRS≥3两组,比较两组患者的一般资料、既往病史、实验室检查结果等。采用Logistic回归分析溶栓后AIS患者神经功能预后不良的危险因素。结果 NLR(OR=1.045, 95%CI:1.032~2.350, P=0.032),平均血小板体积(mean platelet volume, MPV)(OR=4.212, 95%CI:1.074~16.513, P=0.039),MPV×NLR/血小板计数(PLT)(OR=5.711,95%CI:1.342~24.298, P=0.018),血小板分布宽度(platelet distribution width, PDW)(OR=1.015, 95%CI:1.001~2.372, P=0.032),美国国立卫生研究院中风量表(NIHSS)评分(OR=1.266, 95%CI:1.111~1.443, P<0.01)是接受静脉溶栓治疗后AIS患者神经功能预后不良的影响因素。结论 NLR、MPV、MPV×NLR/PLT、PDW、NIHSS评分是溶栓后急性缺血性脑卒中神经功能预后不良的危险因素。MPV×NLR/PLT可以较好地预测3个月后AIS神经功能严重程度。

Objective To investigate the prognostic value of platelet volum e indices(PV Is),neutrophil/lymphocyte ratio(NLR)and the combination of these param eters for the neurological function of acute ischemic stroke(AIS)patients after intravenous thrombolysis.Methods From January 2016 to January 2019,the data of 147 AIS patients with intravenous thrombolysis in the Emergency Department of Peking University People's Hospital who met the diagnostic criteria of AIS were retrospectively analyzed.The patients were divided into two groups according to modified rank in scale(MRS)score:MRS≤2 and MRS≥3.The general information,past medical history and laboratory examination results of each group were compared.Logistic regression analysis was used to analyze the risk factors of poor prognosis of neurological function in AIS patients with thrombolysis.Results NLR(OR=1.045,95%CI:1.032-2.350,P=0.032),mean platelet volume(MPV)(OR=4.212,95%CI:1.074-16.513,P=0.039),MPV×NLR/PLT(OR=5.711,95%CI:1.342-24.298,P=0.018),platelet distribution width(PDW)(OR=1.015,95%CI:1.001-2.372,P=0.032),and NIHSS score(OR=1.266,95%CI:1.111-1.443,P<0.01)were related with poor prognosis neurological function of AIS patients with intravenous thrombolysis.Conclusions MPV,NLR,MPV×NLR/PLT PDW and NIHSS scores are the risk factors for poor prognosis of neurological function in AIS patients with thrombolysis.MPVxNLR/PLT can predict the neurological severity of AIS after 3 months.