中性粒细胞与淋巴细胞比值对急性缺血性脑卒中静脉溶栓患者预后的评估价值

The assessment of the association of NLR with the prognosis of IAS intravenous thrombolysis

目的探讨中性粒细胞与淋巴细胞比值(neutrophil to lymphocyte ratio,NLR)与急性脑梗死静脉溶栓患者预后的关系。方法选择2019年8月至2020年8月在贵州省人民医院神经内科住院治疗的急性脑梗死静脉溶栓患者112例,其中12例患者失联或资料缺失,最终共100例急性脑梗死患者纳入本研究。收集患者的一般临床资料和实验室检查结果。根据患者3个月的改良RanKin量表(mRS)评分将患者分为预后良好组(mRS<3分)与预后不良组(mRS≥3分)。采用Logistic回归分析与临床结局有关的危险因素,通过受试者工作特征(ROC)曲线来确定NLR对神经功能预后不良的最佳截断值。结果单因素分析显示,白细胞计数、中性粒细胞计数、淋巴细胞计数及NLR是影响患者神经功能预后的因素。多因素分析结果提示,NLR与神经功能预后不良独立相关(OR 3.036;95%CI,1.089-8.468);NLR对神经功能不良预后的最佳预测截断值为3.98(敏感性为83.3%,特异性为86.8%)。结论NLR是急性脑梗死静脉溶栓患者神经功能预后不良的独立危险因素。

Objective To investigate the association of neutrophil-to-lymphocyte ratio(NLR)with the prognosis of the patients with acute ischemic stroke(AIS)intravenous thrombolysis.Methods Retrospective analysis was carried out among 112 AIS patients with intravenous thrombolysis in Guizhou People’s Hospital from August 2019 and August 2020.General data and laboratory examination results were collected at the admission.The patients were divided into good clinical outcome(mRS<3 scores)group and poor outcome(mRS≥3 scores)group according to their 3 months’scores of the Modified Rankin Scale.The influence of clinical outcome was analyzed by multivariate analysis.Receiver operating characteristic(ROC)curve was performed to identify the optimal cut point of NLR for clinical poor outcome.Results The univariate analysis showed that NEUT,LYM,WBC and NLR were associated with poor clinical outcome.The multivariate analysis showed that the NLR was independently associated with poor clinical outcome(OR 3.036;95%CI,1.089-8.468).The best predictive cut-off of the NLR for poor clinical outcome was 3.98(sensitivity,83.3%;specificity,86.8%).Conclusion NLR is independently predictive of 3-month clinical outcome in patients with AIS.