溶栓后血清白蛋白、淋巴细胞计数、中性粒细胞计数预测急性脑梗死早期神经功能恶化的价值

The value of serum albumin,lymphocyte count and neutrophilic granulocyte count after thrombolysis in predicting the deterioration of nerve function in early acute cerebral infarction

目的 探讨溶栓后血清白蛋白、淋巴细胞计数、中性粒细胞计数预测急性脑梗死早期神经功能恶化(END)的价值。方法 选择2019年1月—2020年9月163例在本院接受阿替普酶静脉溶栓治疗的患者作为研究对象,根据是否出现早期神经功能恶化分为END组36例和非END组127例,比较2组患者一般资料、实验室指标,采用Logistic回归分析影响患者溶栓后END的因素,采用受试者工作特征曲线(ROC)分析实验室指标预测END的价值。结果 END组患者淋巴细胞计数、总蛋白、白蛋白水平明显低于非END组(P <0. 05),END组患者白细胞计数、中性粒细胞计数明显高于非END组(P <0. 05)。Logistic回归分析显示,淋巴细胞计数、中性粒细胞计数、白蛋白、入院时NIHSS评分、责任血管狭窄程度是影响急性脑梗死溶栓后早期神经功能恶化的主要因素(P <0. 05)。ROC曲线分析显示,白蛋白、淋巴细胞计数、中性粒细胞计数预测急性脑梗死溶栓后早期神经功能恶化的AUC分别为0. 683、0. 672、0. 638。结论 溶栓后白蛋白、淋巴细胞计数、中性粒细胞计数与急性脑梗死患者溶栓后早期神经功能恶化有一定关系,可用于预测END的发生。

Objective To investigate the value of serum albumin,lymphocyte count and neutrophil count after thrombolysis in predicting the early neurological deterioration(END)of acute cerebral infarction.Methods A total of 163 patients receiving intravenous thrombolysis with alteplase in our hospital from January 2019 to September 2020 were selected as study subjects.According to the occurrence of early neurological deterioration,all the cases were divided into END group(36 patients)and non-END group(127 patients).The general data and laboratory indexes of the two groups were compared,Logistic regression analysis was used to analyze the factors affecting the END after thrombolysis,and the receiver operating characteristic curve(ROC)was used to analyze the laboratory indicators to predict the value of END.Results The lymphocyte count,total protein and albumin levels in the END group were significantly lower than those in the non-END group(P<0.05),and the white blood cell count and neutrophil count in the END group were significantly higher than those in the non-END group(P<0.05).Logistic regression analysis showed that lymphocyte count,neutrophil count,albumin,baseline NIHSS score,vascular stenosis degree were the main factors affecting the early neurological deterioration after thrombolysis in acute cerebral infarction(P<0.05).ROC curve analysis showed that the AUC of albumin,lymphocyte count and neutrophil count in predicting the early deterioration of nerve function after thrombolysis in acute cerebral infarction was 0.683,0.672 and 0.638,respectively.Conclusion Albumin,lymphocyte count and neutrophil count after thrombolysis are related to the deterioration of nerve function in patients with acute cerebral infarction,and can be used to predict the occurrence of END.