摘要
目的探讨急性缺血性卒中大血管闭塞患者早期中性粒细胞与淋巴细胞水平及两者比值的预测价值。方法根据是否存在大血管闭塞,将120例急性缺血性卒中患者分为大血管闭塞组和非大血管闭塞组。比较两组患者一般临床资料及白细胞计数、中性粒细胞计数和淋巴细胞计数等生化指标,并计算中性粒细胞与淋巴细胞比值(NLR)。采用ROC曲线分析NLR对急性缺血性卒中大血管闭塞的预测价值,采用多变量logistic回归对危险因素进行分析。结果 120例脑卒中患者中大血管闭塞患者51例(42.50%),非大血管闭塞患者69例(57.50%)。两组患者卒中史、心房颤动、NIHSS评分及白细胞计数、中性粒细胞计数、淋巴细胞计数、NLR差异有统计学意义(P<0.05);多因素Logistic回归分析显示,心房颤动、NIHSS评分、白细胞计数及NLR是急性缺血性卒中大血管闭塞的危险因素。ROC曲线下面积为0.785(95%CI:0.672~0.859),敏感度为82.46%,特异度为73.14%,最佳截断值为4.16。结论 NLR、NIHSS评分、白细胞计数得分及心房颤动是急性缺血性卒中大血管闭塞的危险因素,NLR可作为预测急性缺血性卒中大血管闭塞的有效指标。
Objective To evaluate the predictive value of the ratio of the level of neutrophils to that of lymphocytes in diagnosing macrovascular occlusion in patients with acute ischemic stroke. Methods Firstly, 120 patients experiencing acute ischemic stroke were divided into two groups according to whether occlusion was found in the large vessels, namely, macrovascular occlusion group and non-macrovascular occlusion group. The general clinical data, the leukocytes count, the neutrophils count and the lymphocyte count of the two groups were then compared. The ratio of the count of neutrophils to that of lymphocytes(NLR) was calculated. Lastly, ROC curve analysis was conducted to evaluate the role of NLR in diagnosing macrovascular occlusion in association with acute ischemic stroke. Multivariate Logistic regression was conducted to determine the risk factors. Results Of the 120 patients of acute ischemic stroke, 51(42.50%) were found to have developed macrovascular occlusion and 69(57.50%) were found to have had no macrovascular occlusion. Significant differences were found between the two groups in stroke history, atrial fibrillation, NIHSS score, leukocyte count, neutrophil count, lymphocyte count, and NLR(P<0.05). Multivariate Logistic regression analysis showed that atrial fibrillation, NIHSS score, leukocyte count and NLR were the risk factors engendering macrovascular occlusion in association with acute ischemic stroke. The area under the ROC curve is 0.785(95%CI:0.672~0.859). The sensitivity value was 82.46% and the specificity value was 73.14%. The best truncation value was 4.16. Conclusions The scores of NLR, NIHSS and WBC, and the number of atrial fibrillation in the patients with acute ischemic stroke are the risk factors contributing to the incidence of macroscular occlusion in association with acute ischemic stroke. NLR can serve as an effective predictor of macrovascular occlusion in association with acute ischemic stroke.
作者
林俊
潘旭炎
LIN Jun;PAN Xuyan(Department of Neurology,Red Cross Taiwan Compatriot Hospital of Xiangshan Ningbo,Ningbo 315731;Department of Neurosurgery,Huzhou Central Hospital,Huzhou 313003,China)
出处
《健康研究》
CAS
2019年第6期641-644,648,共5页
Health Research
