NLR与PLR预测缺血性进展性脑卒中的临床价值

Clinical Value of NLR and PLR in Predicting Progressive Ischemic Stroke

目的探讨用外周血中中性粒细胞与淋巴细胞比值(Neutrophil to Lymphocyte Ratio,NLR)和血小板与淋巴细胞比值(Platelet to Lymphocyte Ratio,PLR)评估缺血性进展性脑卒中(Progressive Ischemic Stroke,PIS)的预测价值。方法回顾性分析沧州市人民医院神经内科就诊的112例患者,记录两组患者的一般资料及实验室资料等。根据病情是否发生进展分为PIS组(n=42)和非PIS组(n=70),分析两组NLR、PLR水平及组间差异。运用受试者工作特征(ROC)曲线分析其预测价值。结果PIS组患者入院时白细胞计数、中性粒细胞绝对值、血小板计数及NLR、PLR均显著高于非PIS组(P<0.05),淋巴细胞绝对值显著低于非PIS组(P<0.05)。NLR对PIS预测曲线下面积(AUC)为0.843,灵敏度73.0%,特异度87.0%;PLR对预测PIS的AUC为0.748,灵敏度62.0%,特异度87.0%。NLR联合PLR预测临床不发生PIS的AUC为0.840,灵敏度63.0%,特异度94.0%。结论NLR、PLR值越大,缺血性脑卒中患者病情越有可能发生进展,而二者联合预测可能提示病情不易发生进展。

Objective To investigate the predictive value of peripheral blood neutrophil to lymphocyte ratio(NLR)and platelet to lymphocyte ratio(PLR)in evaluating progressive ischemic stroke(PIS).Methods A retrospective analysis of 112 patients in department of neurology of Cangzhou People’s hospital was carried out.The general data and laboratory data of the two groups were recorded.According to the disease progression,the patients were divided into PIS group(n=42)and non PIS group(n=70).The levels of NLR and PLR and the differences between the two groups were analyzed.Receiver operating characteristic(ROC)curve was used to analyze its predictive value.Results The leukocyte count,neutrophil absolute value,platelet count,NLR and PLR in PIS group were significantly higher than those in non PIS group(P<0.05),and lymphocyte absolute value was significantly lower than that in non PIS group(P<0.05).The area under the curve(AUC)of NLR was 0.843,the sensitivity was 73.0%,the specificity was 87.0%.The AUC of PLR was 0.748,the sensitivity was 62.0%,and the specificity was 87.0%.The AUC of NLR combined with PLR was 0.840,the sensitivity was 63.0%,and the specificity was 94.0%.Conclusion The higher the value of NLR and PLR,the more likely the disease will progress in patients with ischemic stroke,and the joint prediction of the two may indicate that the disease is not easy to progress.