摘要
目的明确血液中常见炎症指标与急性基底动脉闭塞(BAO)患者血管内治疗(EVT)临床预后的关联。方法回顾性分析2018年1月至2021年6月于西安交通大学第二附属医院、南京大学医学院附属金陵医院及南京医科大学附属脑科医院前瞻性取栓数据库确诊为急性BAO所致脑梗死并于预计闭塞时间24 h内接受EVT的142例患者。不良预后定义为90 d mRS 3~6分。单因素分析预后良好与预后不良两组患者的一般资料、既往病史、实验室检查结果等差异。多因素Logistics回归分析炎症指标及炎性细胞比率对BAO后EVT患者预后的影响。结果与预后良好组相比,预后不良组的中性粒细胞计数[(9.3±3.9)×10^(9)/L vs.(7.1±4.0)×10^(9)/L,P=0.003)]、中性粒细胞与淋巴细胞比率(NLR)[9.9(5.7,16.0)vs.4.7(2.3,10.6),P<0.001]、血小板与淋巴细胞比率(PLR)[202.4(130.6~317.9)vs.147.4(10^(9).4~199.8),P=0.004]水平较高,淋巴细胞计数[1.0(0.7,1.4)×10^(9)/L vs.1.3(0.9,1.7)×10^(9)/L,P=0.009]较低。多因素回归分析结果显示,NLR(OR=1.216,95%CI:1.026~1.442)、PLR(OR=1.008,95%CI:1.001~1.015)是术后症状性出血的独立危险因素,NLR(OR=1.100,95%CI:1.015~1.192)和中性粒细胞计数(OR=1.137,95%CI:1.013~1.276)是90 d不良功能预后的独立危险因素。结论术前NLR、PLR或可预测急性BAO患者EVT术后症状性出血,NLR和中性粒细胞计数是术后90 d不良功能预后的独立危险因素。
Objective To investigate the relationship between common inflammatory indexes and clinical prognosis of patients with acute basilar artery occlusion(BAO)treated with endovascular therapy(EVT).Methods A total of 142 patients diagnosed with acute BAO and treated with EVT within 24 hours of expected occlusion time were identified from January 2018 to June 2021 in The Second Affiliated Hospital of Xi'an Jiaotong University,The Affiliated Jinling Hospital of Nanjing University and The Affiliated Brain Hospital of Nanjing Medical University were analyzed.Poor outcome was defined as modified Rankin Scale(mRS)3-6 points.Univariate analysis was used to analyze the general data,medical history and laboratory results between the two groups.Multivariate logistic regression analysis was used to analyze the effect of inflammatory indexes on the prognosis of patients with BAO after EVT.Results Compared with good outcome group,the level of neutrophil count[(9.3±3.9)×10^(9)/L vs.(7.1±4.0)×10^(9)/L,P=0.003],NLR[9.9(5.7,16.0)vs.4.7(2.3,10.6),P<0.001],PLR[202.4(130.6~317.9)vs.147.4(10^(9).4,199.8),P=0.004]and were higher,and lymphocyte count[1.0(0.7,1.4)×10^(9)/L vs.1.3(0.9,1.7)×10^(9)/L,P=0.009]was lower in poor outcome group.Multivariate logistic regression demonstrated that NLR(OR=1.216,95%CI:1.026-1.442)and PLR(OR=1.008,95%CI:1.001-1.015)were independent risk factors for sICH.NLR(OR=1.100,95%CI:1.015-1.192)and neutrophil count(OR=1.137,95%CI:1.013-1.276)were independent risk factors for 90 day poor functional prognosis.Conclusion Preoperative NLR and PLR may could predict sICH after EVT of acute BAO.NLR and neutrophil count are independent risk factors for 90 day poor functional outcome after EVT.
作者
刘锋昌
胡海颍
张盼
肖露露
孙文
蓝文雅
张桂莲
LIU Feng-chang;HU Hai-ying;ZHANG Pan(Department of Neurology,The Second Affiliated Hospital of Xi'an Jiaotong University,Xi'an Shaanxi 710000,China;Department of Neurology&Cerebrovascular Disease Center,The First Affiliated Hospital of University of Science and Technology,Hefei Anhui 230041,China)
出处
《临床和实验医学杂志》
2023年第18期1918-1922,共5页
Journal of Clinical and Experimental Medicine
基金
安徽省重点研发项目(编号:202104j07020049)
安徽省自然科学基金(编号:2108085MH271)。
