白细胞计数、中性粒细胞绝对值及相对值与青年卒中患者预后的相关性研究

Association between white blood cell count,absolute and relative neutrophil count and prognosis in young patients with ischemic stroke

目的探讨白细胞计数(white blood cell count,WBC)、中性粒细胞绝对值(absolute neutrophil count,ANC)及相对值(relative neutrophil count,RNC)与青年卒中患者出院时神经功能缺损、不良预后及90 d不良预后的相关性。方法本研究为回顾性研究,纳入18~45岁发病72 h到院的首次缺血性卒中患者,以出院时NIHSS评分,出院时和90 d mRS评分为结局评价指标,采用多因素Logistic回归分别分析WBC四分位分组、ANC、RNC与中重度神经功能缺损(NIHSS评分>4分)和不良预后(mRS评分2~5分)的关系。结果WBC>7.82×10^(9)/L与出院时中重度神经功能缺损和90 d预后不良独立相关,ANC仅与90 d预后不良独立相关,而RNC与出院时中重度神经功能缺损、预后不良及90 d预后不良均独立相关。结论WBC>7.82×10^(9)/L是青年卒中患者出院时中重度神经功能缺损及90 d预后不良的独立危险因素。RNC升高比ANC更具有提示作用,其与出院时中重度神经功能缺损、预后不良及90 d预后不良的独立相关。

Objective This study aims to explore the correlation between white blood cell count(WBC),absolute neutrophil count(ANC),relative neutrophil count(RNC)and neurological impairment,poor prognosis at discharge and 90 days after onset.Methods This study was a retrospective study,including patients aged 18 to 45 years old with first ischemic stroke within 72 hours.NIHSS score at discharge,mRS score at discharge and 90 days were used as outcome.Multivariate logistic regression was used to analyze the relationship between WBC quartile,ANC,RNC and neurological deficit(NIHSS score>4)and poor prognosis(mRS score 2~5).Results WBC>7.82×10^(9)/L was independently associated with moderate and severe neurological deficit at discharge and poor prognosis at 90 days.The ANC was only associated with poor prognosis at 90 days,independently.The RNC was an independent risk factor for moderate and severe neurological impairment at discharge,poor prognosis at discharge and 90 days.Conclusion WBC>7.82×10^(9)/L is an independent risk factor for moderate and severe neurological impairment at discharge and poor prognosis at 90 days in young patients with stroke.The increase of RNC,which is independently related to moderate and severe neurological impairment and poor prognosis,is more indicative than ANC for poor prognosis in young patients with stroke.