NLR联合MPV预测老年急性缺血性脑卒中病人静脉溶栓治疗预后的临床价值

Clinical predictive value of NLR combined with MPV on prognosis of intravenous thrombolysis in elderly patients with acute ischemic stroke

目的探析中性粒细胞/淋巴细胞比率(NLR)联合平均血小板体积(MPV)对老年急性缺血性脑卒中(AIS)病人静脉溶栓治疗预后的临床预测价值。方法选择本院2017年1月至2020年6月接受静脉溶栓治疗的老年AIS病人76例,收集病人的一般资料、临床资料,根据改良Rankin量表(mRS)评分分为预后良好组(≤2分)和预后不良组(>2分),检测并比较2组WBC、中性粒细胞计数(N)、淋巴细胞计数(L)、NLR、血小板计数/淋巴细胞计数的比值(PLR)、PLT、MPV、血小板分布宽度(PDW)、TG、LDL-C、Hcy、TC、肌酐水平。采用多因素Logistic回归分析接受静脉溶栓治疗的老年AIS病人预后不良的危险因素;绘制ROC曲线评估NLR联合MPV对老年AIS病人静脉溶栓治疗预后的预测价值。结果预后不良组病人WBC、NLR、PLR、MPV水平及NIHSS评分高于预后良好组(P<0.05);多因素Logistic回归模型显示,NLR和MPV是接受静脉溶栓治疗的老年AIS病人预后不良的独立影响因素。ROC曲线分析结果显示,NLR+MPV联合评估老年AIS病人预后不良的AUC为0.845(95%CI:0.798~0.957),灵敏度为88%,特异度为91%,有较好的预测价值。结论NLR联合MPV对老年AIS病人静脉溶栓治疗预后的预测价值较高。

Objective To explore the clinical predictive value of neutrophil-lymphocyte ratio(NLR)combined with mean platelet volume(MPV)on prognosis of intravenous thrombolysis in the elderly patients with acute ischemic stroke(AIS).Methods A total of 76 elderly patients with AIS who received intravenous thrombolysis in our hospital from January 2017 to June 2020 were selected and divided into good prognosis group(≤2 points)and poor prognosis group(>2 points)according to Modified Rankin Scale(MRS).The general information and clinical data of the patients were collected,and the levels of white blood cell count(WBC),neutrophil count(N),lymphocyte count(L),NLR,platelet count-lymphocyte count ratio(PLR),platelet count(PLT),MPV,platelet distribution width(PDW),triglycerides(TG),low-density lipoprotein cholesterol(LDL-C),homocysteine(Hcy),total cholesterol(TC)and creatinine were detected and compared between the two groups.Multiple Logistic regression analysis was used to analyze the risk factors for poor prognosis.Receiver operating characteristic(ROC)curve was used to evaluate the effect of NLR combined with MPV on the prognosis of intravenous thrombolysis in the elderly patients with AIS.Results The levels of WBC,NLR,PLR,MPV and National Institute of Health Stroke Scale(NIHSS)score in the poor prognosis group were significantly higher than those in the good prognosis group(P<0.05).Multiple Logistic regression analysis showed that NLR and MPV were the independent influencing factors of poor prognosis(P<0.05).ROC curve analysis showed that the area under the curve(AUC)of NLR combined with MPV was 0.845(95%CI:0.798-0.957),with a sensitivity of 88%,and a specificity of 91%.Conclusions NLR combined with MPV has a high predictive value for the prognosis of intravenous thrombolysis in the elderly patients with AIS.