红细胞分布宽度和血小板计数比值与老年急性脑梗死体积的相关性

Relationship between RBC distribution width/platelet ratio and acute cerebral infarction size in the elderly

目的探讨红细胞分布宽度(RDW)和血小板计数(PLT)比值(RPR)与老年急性脑梗死体积的相关性。方法回顾性纳入2017年1月~2020年7月解放军总医院第六医学中心神经内科住院发病7 d内的急性脑梗死患者108例(脑梗死组),脑梗死组根据头颅MRI结果分为腔隙性脑梗死组38例,中梗死组30例和大梗死组40例,另选择同期住院的非脑梗死患者85例(对照组),采用Spearman相关性分析和多因素logistic回归分析RPR与脑梗死体积的相关性。结果脑梗死组RPR、RDW明显高于对照组,PLT明显低于对照组(P<0.01)。大梗死组RPR、RDW较中梗死组及腔隙性脑梗死组明显升高,PLT较腔隙性脑梗死组明显降低(P<0.05,P<0.01);中梗死组RPR、RDW较腔隙性脑梗死组明显升高(P<0.05)。RPR对老年中梗死和大梗死预测的ROC曲线下面积为0.747(95%CI:0.651~0.842,P<0.01),最佳临界值为0.063,敏感性为70.0%,特异性为73.7%。Spearman相关性分析显示,RPR和RDW与脑梗死体积呈正相关(r=0.465,P<0.01;r=0.401,P<0.01),PLT与脑梗死体积呈负相关(r=-0.342,P<0.01)。多因素logistic回归分析显示,RPR升高是中梗死和大梗死的危险因素(OR=2.455,95%CI:1.391~4.331,P=0.002)。结论RPR是老年脑梗死体积的危险因素。

Objective To study the relationship between RBC distribution width(RDW)/platelet ratio(RPR)and acute cerebral infarction(ACI)size in the elderly.Methods One hundred and eight ACI admitted to Chinese PLA General Hospital No.6 Medical Center from January 2017 to July 2020 served as an ACI group.The patients were further divided into lacunar group(n=38),medium group(n=30)and large group(n=40)according to their cranial MRI with 85 cerebral infarction-free patients served as a control group.The relationship between between RPR and cerebral infarction size was analyzed by Spearman correlation analysis and multivariate logistic regression analysis respectively.Results The RPR and RDW were significantly higher while the platelet count was significantly lower in ACI group than in control group(P<0.01).The RPR and RDW were significantly higher in large group than in lacunar group and medium group while the platelet count was significantly lower in large group than in lacunar group(P<0.05,P<0.01).The RPR and RDW were significantly higher in medium group than in lacunar group(P<0.05).The AUC for RPR in predicting medium infarction size and large infarction size in elderly ACI patients was 0.747(95%CI:0.651-0.842,P<0.01)with an optimal cutoff value of 0.063,a sensitivity of 70.0%,and a specificity of 73.7%.Spearman correlation analysis showed that the RPR and RDW were positively related with cerebral infarction size and platelet count was negatively related with cerebral infarction size in elderly ACI patients(r=0.465,P<0.01;r=0.401,P<0.01;r=-0.342,P<0.01).Multivariate logistic regression analysis displayed that elevated RPR was a risk factor for meidum infarction size and large infarction size in elderly ACI patients(OR=2.455,95%CI:1.391-4.331,P=0.002).Conclusion RPR is a risk factor for cerebral infarction size in elderly ACI patients.