摘要
目的分析白细胞计数/平均血小板体积(white blood cell count to mean platelet volume ratio,WMR)与急性脑梗死(acute cerebral infarction,ACI)患者近期预后的关系。方法招募2015年9月-2019年12月就诊于我院神经内科的ACI患者134例,收集所有患者临床基线资料、NHISS评分及实验室检测指标及出院后30d内预后情况,根据患者预后情况,分为预后不良组(n=26)及预后良好组(n=108),分析两组患者临床资料之间的差异,通过ROC曲线评估WMR等临床指标对ACI患者近期预后不良的诊断价值,应用COX比例风险回归模型分析WMR与ACI预后不良的相关性。结果①预后不良组患者LDL-C、WBC、MPV、WMR及NIHSS评分水平显著高于预后良好组(P<0.05);②WMR预测ACI近期预后不佳的价值最高,曲线下面积(AUC)(95%CI)为0.86(0.79~0.93),显著高于其他指标,差异具备统计学意义;③COX比例风险回归模型发现,MPV、NIHSS评分、WMR是ACI患者近期预后不良的独立危险因素,三者危险比(HR)(95%CI)分别为1.04(1.01~1.15).1.61(0.84~3.11)及1.62(0.61~4.34)。结论WMR是潜在的预测ACI患者近期预后不佳的标记物,其水平升高与ACI预后不良密切相关。
Objective To analyze the relationship between the white blood cell count to mean platelet volume ratio(WMR)and short-term prognosis in acute cerebral infarction(ACI)patients.Methods 134 ACI patients,aged 54~81,were hospitalized and underwent routine treatment.The baseline data were explored.Samples of peripheral ve-nous blood were collected at admission to test the blood routine and blood lipids so as to measure the WMR lev-els.,National Institute of Health Stroke Scale(NIHSS)was used to investigate the severity of ACI.Telephone fol-low-up(or follow-up of other form)was conducted for 30 days at most to know the terminal events.and 26 ACI patients with poor prognosis severed as poor outcome,the others as good outcome.The clinical data were compared with two groups,receiver operating characteristic(ROC)curve were used to analyze the value of WMR and other clinical indicators for poor outcome in ACI patienls,what's more,to explore the correlation between WMR and poor outcome by using C0X proportional hazard regression model.Results Positive outcome was shown in 108 of the 134 patients and poor outcome in 26.This study suggested that(1)the levels of WMR,low density lipoprotein cholesterol(LDL-C),white blood cell(WBC),mean platelet volume(MPV)and NIHSS were all significantly higher in the poor outcome group than in the positive outcome group(all P<0.05).;(2)The value of WMR for predicting the poor outcome in ACI patients was highest than other indicators,the area under the curve(AUC)(95%CI)was 0.86(0.79-0.93);(3)COX proportional hazard regression model found that MPV,NIHSS and WMR served as inde-pendent risk factors for poor outcome in ACI patients,with the hazard ratios(95%CI)of 1.04(1.01-1.15),1.61(0.84-3.11),and 1.62(0.61-4.34)respectively.Conclusion WMR is a potential predictor of poor outcome in ACI patients.
作者
郑芳昆
龙登毅
贝筝
于航
ZHENG Fangkun;LONG Dengyi;BEI Zheng;YU Hang(Department of Neurology,Hainan Cadre Sanatorium(Hainan Geriatric Hospital),Haikou 571100,China)
出处
《中国急救复苏与灾害医学杂志》
2021年第2期139-142,共4页
China Journal of Emergency Resuscitation and Disaster Medicine
基金
海南省高等学校科学研究项目(编号:Hnky2O18-5O)。
关键词
白细胞/血小板平均体积
急性脑梗死
预后
White blood cell count to mean platelel volume ratio
Aute cerebral infarction
Outcome
