红细胞分布宽度、中性粒细胞与淋巴细胞比值和脑小血管病影像学总负荷的相关性分析

Correlation analysis of red blood cell distribution width and neutrophil to lymphocyte ratio with total imaging load of cerebral small vessel disease

目的探讨脑小血管病(cerebral small vessel disease,CSVD)患者红细胞分布宽度(red blood cell distribution width,RDW)、中性粒细胞与淋巴细胞比值(neutrophil to lymphocyte ratio,NLR)与CSVD影像学总负荷的相关性。预测RDW、NLR及其联合指标对CSVD影像学高负荷的临床诊断价值。方法回顾性收集2018年10月—2022年10月在包头市中心医院神经内科住院治疗的CSVD患者的病历资料。通过评估头颅MRI得出CSVD影像学总负荷并将纳入患者分为低负荷组和高负荷组。比较两组间的一般临床资料、既往病史、血生化指标水平,使用相关性分析方法分析相关指标与CSVD影像学总负荷的关系,使用logistic回归分析方法分析CSVD影像学总负荷的危险因素,绘制受试者操作特征曲线评估检测指标对于临床的诊断价值。结果共纳入患者320例。其中,低负荷组201例(62.81%),高负荷组119例(37.19%)。除年龄、性别、高血压病史、RDW、NLR外(P<0.05),其余指标两组间的比较差异均无统计学意义(P>0.05)。Spearman相关性分析结果显示,RDW(r=0.445,P<0.001)、NLR(r=0.309,P<0.001)与CSVD影像学总负荷均呈正相关。多因素logistic回归分析结果显示,年龄、男性、RDW、NLR是导致CSVD影像学高负荷的危险因素。RDW、NLR及其联合指标预测发生CSVD的受试者工作特征曲线下的面积分别是0.733、0.644、0.792。结论在CSVD患者中,RDW及NLR水平与CSVD影像学总负荷相关,是导致CSVD影像学高负荷的独立危险因素。RDW、NLR水平对预测CSVD影像学高负荷有临床诊断价值。

Objective To investigate the correlation of red blood cell distribution width(RDW)and neutrophil to lymphocyte ratio(NLR)with total imaging load of cerebral small vessel disease(CSVD),and the clinical diagnostic value of RDW,NLR and their combined indicators for high load of CSVD imaging.Methods The medical records of CSVD patients hospitalized in the Department of Neurology of Baotou Central Hospital between October 2018 and October 2022 were retrospective collected.The total imaging load of CSVD was obtained by evaluating the cranial MRI and divided into a low load group and a high load group.The general clinical data,past medical history,and blood biochemical indicators were compared between the two groups.The correlation analysis method was used to analyze the relationship between the relevant indicators and the total imaging load.Logistic regression analysis was used to analyze the risk factors of the total imaging load of CSVD.The receiver operating characteristic(ROC)curve was used to evaluate the diagnostic value of the detection indicators for clinical diagnosis.Results A total of 320 patients were included.Among them,there were 201 cases(62.81%)in the low load imaging group and 119 cases(37.19%)in the high load imaging group.Excepted for age,gender,history of hypertension,RDW,and NLR(P<0.05),there was no statistically significant difference in the comparison of other indicators between the two groups(P>0.05).Spearman correlation analysis showed that RDW(r=0.445,P<0.001)and NLR(r=0.309,P<0.001)were positively correlated with the total imaging load of CSVD.The results of multivariate logistic regression analysis showed that age,male gender,RDW,and NLR were risk factors for high imaging load of CSVD.The areas under the ROC curve of RDW,NLR,and their combined indicators were 0.733,0.644,and 0.792,respectively.Conclusions In patients with CSVD,the levels of RDW and NLR are related to the total imaging load of CSVD,which are independent risk factors for high imaging load of CSVD.The levels of RDW and NLR have clinical diagnostic value in predicting CSVD high load.