中性粒细胞与淋巴细胞比值和平均血小板体积对急性脑梗死早期神经功能恶化的预测价值

Value of neutrophil-lymphocyte ratio and mean platelet volume in predicting early neurological function deterioration in patients with acute ischemic stroke

目的探讨入院时中性粒细胞与淋巴细胞比值(NLR)和平均血小板体积(MPV)对急性脑梗死患者早期神经功能恶化(END)的预测价值。方法回顾性分析172例急性脑梗死患者的临床资料,根据是否发生END将患者分为END组和非END组。分析2组患者的基线资料,应用Spearman相关性分析法分析NLR、MPV与血管负荷的相关性,应用多因素Logistic回归分析对END的危险因素进行分析,并应用受试者工作特征(ROC)曲线评价NLR、MPV对END的预测价值。结果NLR与血管狭窄数目(r=0.453,P<0.001)、狭窄程度(r=0.307,P<0.001)均呈正相关;MPV与血管狭窄数目呈正相关(r=0.246,P<0.001)。NLR(OR=2.771,95%CI为1.163~6.600,P=0.021)、MPV(OR=3.138,95%CI为1.772~5.556,P<0.001)是END的独立影响因素。ROC曲线显示,NLR、MPV预测END的曲线下面积分别为0.722(95%CI为0.624~0.820,P<0.001)、0.770(95%CI为0.690~0.849,P<0.001)。NLR最佳临界值为3.6,MPV最佳临界值为8.3 f L,NLR、MPV预测END的敏感度分别为40.6%、93.8%,特异度分别为92.9%,50.7%。结论入院时NLR、MPV是END的独立影响因素,对急性脑梗死患者END具有一定预测价值。

Objective To explore the value of neutrophil-lymphocyte ratio(NLR)and mean platelet volume(MPV)in predicting early neurological deterioration(END)in patients with acute ischemic stroke.Methods A retrospective analysis was performed for 172 patients with acute cerebral infarction,and they were divided into END group and non-END group according to occurrence of END.The baseline data of the two groups was analyzed,the correlations between NLR,MPV and vascular load were analyzed by Spearman correlation,the risk factors of END were analyzed by multivariate Logistic regression,and the value of NLR and MPV in predicting early neurological deterioration was evaluated by Receiver Operation Characteristic(ROC)curve.Results NLR was positively correlated with the number of stenosis(r=0.453,P<0.001)and the degree of stenosis(r=0.307,P<0.001),while MPV was positively correlated with the number of stenosis(r=0.246,P<0.001).NLR(OR=2.771,95%CI,1.163 to 6.600,P=0.021)and MPV(OR=3.138,95%CI,1.772 to 5.556,P<0.001)were independent risk factors for END.The ROC curve showed that the areas under the curve predicted by NLR and MPV were 0.722(95%CI,0.624 to 0.820,P<0.001)and 0.770(95%CI,0.690 to 0.849,P<0.001),and their best cutoff values were 3.6 and 8.3 f L,respectively.The sensitivities of NLR and MPV were 40.6%and 93.8%,respectively,and the specificities were 92.9%and 50.7%,respectively.Conclusion NLR and MPV are independent risk factors of END at admission,which have certain value in predicting the occurrence of END in patients with acute ischemic stroke.