NLR、PNR、Hcy对大面积脑梗死患者预后的预测价值分析

Prognostic Value of NLR,PNR and Hcy in Patients with Massive Cerebral Infarction

目的:探讨中性粒细胞与淋巴细胞比值(NLR)、血小板与中性粒细胞比值(PNR)及同型半胱氨酸(Hcy)对大面积脑梗死患者预后的预测价值。方法:选择2019年1月—2022年6月在南华大学附属怀化医院神经内科确诊为大面积脑梗死患者209例作为研究对象,均给予临床综合治疗,治疗后3个月进行随访,根据改良Rankin量表(mRS)评分将其分为预后良好组(mRS评分≤2分)和预后不良组(mRS评分>2分)。比较两组相关临床资料,分析大面积脑梗死患者预后不良的影响因素以及NLR、PNR、Hcy对大面积脑梗死患者预后的预测价值。结果:血小板计数、中性粒细胞计数、淋巴细胞计数、NLR、PNR、Hcy均是大面积脑梗死患者预后不良的独立影响因素(P<0.05)。NLR、PNR、Hcy及三者联合检测预测大面积脑梗死患者预后的受试者操作特征曲线下总面积分别为0.707、0.680、0.741、0.789。结论:血清NLR、PNR、Hcy水平与大面积脑梗死患者病情发展密切相关,对大面积脑梗死患者预后有一定预测价值。

Objective:To investigate the prognostic value of neutrophil to lymphocyte ratio(NLR),platelet to neutrophil ratio(PNR)and homocysteine(Hcy)in patients with massive cerebral infarction.Methods:A total of two hundred and nine patients diagnosed with massive cerebral infarction in the Department of Neurology of Huaihua Hospital Affiliated to the University of South China from January 2019 to June 2022 were selected as the study objects,and all of them were given comprehensive clinical treatment.The patients were followed up 3 months after treatment and divided into good prognosis group(mRS Score≤2 points)and poor prognosis group(mRS Score>2 points)according to the modified Rankin Scale(mRS)score.The relevant clinical data of the two groups were compared to analyze the influencing factors of poor prognosis in patients with massive cerebral infarction and the prognostic value of NLR,PNR and Hcy in patients with massive cerebral infarction.Results:Platelet count,neutrophil count,lymphocyte count,NLR,PNR and Hcy were all independent influencing factors for poor prognosis in patients with large area cerebral infarction(P<0.05);the total area under the subject operation characteristic curve of NLR,PNR,Hcy and their combined detection to predict the prognosis of patients with large area cerebral infarction were 0.707,0.680,0.741 and 0.789,respectively.Conclusion:Serum NLR,PNR and Hcy levels are closely related to the development of patients with large area cerebral infarction,and have certain prognostic value for patients with large area cerebral infarction.