摘要
目的探讨外周血中性粒细胞与淋巴细胞比值(neutrophil to lymphocyte ratio,NLR)对短暂性脑缺血发作(transient ischemic attack,TIA)后早期卒中风险的预测价值。方法回顾性纳入2015年8月至2017年7月期间天津医科大学第二医院神经内科收治的TIA患者,根据TIA发病后90d内是否发生缺血性卒中分为卒中组和非卒中组。采用多变量logistic回归分析确定TIA后早期卒中发病的独立危险因素,并采用受试者工作特征曲线评价基线NLR对TIA后早期卒中风险的预测价值。结果共纳入131例TIA患者,其中23例(17.5%)在90d内发生卒中,主要集中在TIA发病后7 d内(13例,56.5%)。单变量分析显示,卒中组年龄.ABCD2评分、高血压、症状持续时间≥60min、糖尿病、三酰甘油、基线NLR、颅内动脉狭窄、抗血小板药及双重抗血小板药等与非卒中组差异有统计学意义(P均<0.05)。多变量logistic回归分析显示,校正混杂因素后,基线NLR[优势比(oddsratio,OR)2.631,95%可信区间(confidence interval,CI)1.372-5.046;P=0.004]和ABCD^2评分(OR3.049,95%CI 1.130-8.226;P=0.028)是TIA后早期发生卒中的独立危险因素,而双重抗血小板药(OR 0.195,95%CI 0.046-0.826;P=0.026)是其独立保护因素。受试者工作特征曲线分析显示,当NLR截断值为2.84时,曲线下面积为0.803(95%CI 0.716-0.889),预测TIA后早期卒中风险的敏感性和特异性分别为80.8%和69.5%。结论基线NLR较高对TIA后早期卒中风险具有一定的预测价值。
Objective To investigate the predictive value of peripheral blood neutrophil to lymphocyte ratio(NLR)for early stroke risk after transient ischemic attack(TIA).Methods Patients with TIA admitted to the Department of Neurology,the Second Hospital of Tianjin Medical University from August 2015 to July 2017 were enrolled retrospectively.According to whether or not ischemic stroke occurred within 90 d after the onset of TIA,they were divided into stroke group and non-stroke group.Multivariate logistic regression analysis was used to determine the independent risk factors for early stroke after TIA,and the receiver operating characteristic curve was used to evaluate the predictive value of baseline NLR for early stroke risk after TIA.Results A total of 131 patients with TIA were enrolled.Among them,23(17.5%)had a stroke within 90 d,mainly within 7 d after the onset of TIA(n=13,56.5%).Univariate analysis showed that the differences between the two groups were statistically significant in terms of age,ABCD^2 score,hypertension,duration of symptoms≥60 min,diabetes,triglyceride,baseline NLR level,intracranial artery stenosis,use of antiplatelet drugs and dual antiplatelet drugs(all P<0.05).Multivariate logistic regression analysis showed that after adjusting for the con founding factors,the baseline NLR level(odds ratio[OR]2.631,95%confidence interval[CI]1.372-5.046;P=0.004)and ABCD2 score(OR 3.049,95%CI 1.130-8.226;P=0.028)were the independent risk factors for early stroke after TIA,and use of dual antiplatelet agents(OR 0.195,95%CI 0.046-0.826;P=0.026)were the independent protective factor.The receiver operating characteristic curve analysis showed that when the NLR cut-off value was 2.84,the area under the curve was 0.803(95%CI 0.716-0.889),and the sensitivity and specificity of predicting early stroke risk after TIA were 80.8%and 69.5%,respectively.Conclusion Higher baseline NLR has certain predictive value for early stroke risk after TIA.
作者
魏婵娟
田文洁
夏晓爽
李新
Wei Chanjuan;Tian Wenjie;Xia Xiaoshuang;Li Xin(Department of Neurology,the Second Hospital of Tianjin Medical University,Tiatyin 300211,China)
出处
《国际脑血管病杂志》
2019年第5期332-336,共5页
International Journal of Cerebrovascular Diseases
基金
天津市自然科学基金(16JCYBJC25500)
天津市卫生计生委攻关课题(15KG136)
天津市教委社会科学重大项目(2017JWZD36).
