白细胞及各亚型异常对急性基底动脉缺血性脑卒中预后的影响

The effect of abnormal leukocytes and various subtypes on prognosis of acute basilar artery ischemic stroke

目的 通过分析急性基底动脉缺血性脑卒中患者的临床资料,旨在探究急性基底动脉缺血性脑卒中早期白细胞及各亚型变化与预后情况的关系。方法 回顾性分析2017-09—2021-12河南大学第一附属医院经3.0T磁共振明确诊断的急性基底动脉缺血性脑卒中患者临床资料。应用90 d随访改良Rankin评分(mRS)评定患者神经功能恢复情况,mRS>3分表示预后不良。运用SPSS 24.0统计软件进行数据分析,应用Logistic回归分析得出影响预后的相关因素。结果 预后不良组外周血白细胞计数、中性粒细胞数目、中性粒细胞百分比、淋巴细胞数目、单核细胞数目、中性粒细胞数目/淋巴细胞数目(NLR)、淋巴细胞数目/单核细胞数目(LMR)、血小板计数/淋巴细胞数目(PLR)较预后良好组明显升高,差异有统计学意义(P<0.05);多因素Logistic回归分析显示,PLR高提示预后不良,中性粒细胞百分比>70%(OR:0.125;95%CI:0.012~1.187)、NLR高(OR:1.621;95%CI:0.979~2.681)是预后不良的影响因素(P<0.1)。结论 中性粒细胞百分比增加、NLR和PLR较高提示不良预后可能性大。

Objective By analyzing the clinical data of patients with acute basilar artery ischemic stroke,the aim was to investigate the relationship between the changes of white blood cells and subtypes and the progno⁃sis in the early stage of acute basilar artery ischemic stroke.Methods The clinical data of patients with acute basilar ischemic stroke diagnosed by 3.0T MRI in the First Affiliated Hospital of Henan University from Septem⁃ber 2017 to December 2021 were retrospectively analyzed.Neurological recovery was assessed by modified Rankin Scale(mRS)at 90-day follow-up,and mRS>3 indicated poor prognosis.SPSS 24.0 statistical software was used for data analysis,and Logistic regression analysis was used to obtain the related factors affecting the prognosis.Re⁃sults Peripheral white blood cell count,neutrophil count,neutrophil%,lymphocyte count,monocyte count,neutro⁃phil count/lymphocyte count(NLR),lymphocyte count/monocyte count(LMR),and platelet count/lymphocyte count(PLR)were significantly higher in the poor prognosis group than in the good prognosis group,with signifi⁃cant differences(P<0.05);multivariate Logistic regression analysis showed that high PLR indicated poor progno⁃sis,and neutrophil%>70%(OR:0.125;95%CI:0.012-1.187)and high NLR(OR:1.621;95%CI:0.979-2.681) were factors influencing poor prognosis(P<0.1). Conclusion Increased neutrophil percentage,higher NLR andPLR indicate a high likelihood of poor prognosis.