白细胞计数联合脂蛋白(a)对急性缺血性脑卒中患者溶栓治疗短期预后的预测价值

Prediction Value of White Blood Cell Count Combined with Lipoprotein(a)on Short-term Prognosis of Patients with Acute Ischemic Stroke Treated with Thrombolytic Therapy

目的:探究白细胞计数(WBC)联合脂蛋白(a)[Lp(a)]对急性缺血性脑卒中患者溶栓治疗短期预后的预测价值。方法:选取2021年6月—2023年1月阜宁县人民医院收治的100例急性缺血性脑卒中患者。所有患者均进行溶栓治疗,收集所有患者一般资料,检测所有患者相关指标。治疗2周后,根据患者预后情况将其分为预后良好组和预后不良组。分析分组情况,比较两组一般资料及相关指标。分析急性缺血性脑卒中患者溶栓治疗短期预后不良的影响因素。分析WBC、Lp(a)对急性缺血性脑卒中患者溶栓治疗短期预后的预测价值。结果:100例急性缺血性脑卒中患者中,预后不良30例,占比为30.00%,纳入预后不良组;预后良好70例,占比为70.00%,纳入预后良好组。预后不良组Lp(a)、WBC水平均高于预后良好组,差异有统计学意义(P<0.05)。logistic结果显示,Lp(a)及WBC高水平均为急性缺血性脑梗死溶栓治疗短期预后不良的危险因素(P<0.05)。ROC分析显示,Lp(a)、WBC及联合的敏感度分别为75.76%、86.54%、68.92%,特异度分别为65.65%、57.54%、91.53%,曲线下面积(AUC)分别为0.707、0.737、0.795,联合检测的预测效能最高。结论:Lp(a)及WBC表达水平偏高的急性缺血性脑卒中患者更易出现预后不良的情况,且Lp(a)联合WBC可有效预测急性缺血性脑卒中患者溶栓后的短期预后。

Objective:To investigate the prediction value of white blood cell count(WBC)combined with lipoprotein(a)[Lp(a)]on short-term prognosis of patients with acute ischemic stroke treated with thrombolytic therapy.Method:A total of 100 patients with acute ischemic stroke treated in Funing County People's Hospital from June 2021 to January 2023 were selected.All patients underwent thrombolytic therapy,general data of all patients were collected,and related indicators of all patients were detected.After 2 weeks of treatment,patients were divided into good prognosis group and bad prognosis group according to their prognosis condition.The grouping situation was analyzed,and the general information and relevant indicators of the two groups were compared.The influcing factors affecting short-term prognosis of patients with acute ischemic stroke treated with thrombolytic therapy was analyzed.The predictive value of WBC and Lp(a)on short-term prognosis of patients with acute ischemic stroke undergoing thrombolytic therapy was analyzed.Result:Among 100 patients with acute ischemic stroke,30 had poor prognosis,accounting for 30.00%,and were included in the poor prognosis group.70 cases with good prognosis,accounting for 70.00%,and were included in the good prognosis group.Lp(a)and WBC levels in the poor prognosis group were higher than those in the good prognosis group,and the differences were statistically significant(P<0.05).logistic results showed that high levels of Lp(a)and WBC were both risk factors for poor short-term prognosis after thrombolytic therapy in acute ischemic cerebral infarction(P<0.05).ROC analysis showed that the sensitivity of Lp(a),WBC and combination were 75.76%,86.54%and 68.92%respectively,the specificity was 65.65%,57.54%and 91.53%respectively,and the area under the curve(AUC)was 0.707,0.737 and 0.795 respectively.The combined detection had the highest prediction efficiency.Conclusion:Acute ischemic stroke patients with high expression levels of Lp(a)and WBC are more likely to have poor prognosis,and Lp(a)combined with WBC can effectively predict the short-term prognosis of acute ischemic stroke patients after thrombolysis.