入院当日白细胞状况对急性缺血性脑卒中出院当日MRS评分的影响  

Correlation between leukocyte and MRS score of discharged patients with acute ischemic stroke

作　　者：周硕[1] 孙秀艳[1] 佟伟军[2] Zhou Shuo;Sun Xiuyan;Tong Weijun(Department of Neurology,the Fuxin Central Hospital,Liaoning 123000,China)

机构地区：[1]阜新市中心医院,辽宁123000 [2]苏州大学医学部公共卫生学院流行病与卫生统计学教研室

出　　处：《脑与神经疾病杂志》2019年第2期67-72,共6页Journal of Brain and Nervous Diseases

基　　金：国家自然科学基金项目(81172760)

摘　　要：目的探讨入院当日白细胞计数和中性粒细胞比率对急性缺血性脑卒中(AIS)患者出院当日MRS评分的影响,为科学评估住院期间病情转归提供依据。方法采用回顾性队列研究的方法,录入2011.6.1-2014.6.1阜新市中心医院3151例AIS患者,收集人口统计学、生活方式及入院当日白细胞计数,中性粒细胞比率等血常规信息。出院当日按照生活质量评分量表(MRS)评分将研究对象分为2组:MRS≥3分为神经功能缺损组,MRS<3分为对照组。按照白细胞计数(≤10.0×10~9·L^(-1),10.1～11.0×10~9·L^(-1),11.1～12.0×10~9·L^(-1),≥12.1×10~9·L^(-1))水平将研究对象分为4组,按照中性粒细胞比率(≤70.00%,70.01-80.00%,≥80.01%)将研究对象分为3组,采用Logistic回归分析白细胞计数及中性粒细胞比率对AIS出院当日MRS评分的影响。结果 MRS≥3分组的白细胞计数、中性粒细胞比率均高于MRS<3分组,差异有统计学意义(P<0.05);经多因素校正后,白细胞计数与第1组相比,第2、3和4组均增加了AIS发生MRS评分增高神经功能缺损的风险,OR值及95%CI分别为1.700(1.103～2.620),2.756(1.714～4.433),3.355(2.453～4.589);中性粒细胞比率与第1组相比,第2和3组均增加了AIS患者MRS评分增高神经功能缺损的风险;并且随着白细胞计数和中性粒细胞比率的增加,残疾和死亡复合结局的风险也随着增加(P趋势性检验<0.0001)。结论 AIS患者入院当日白细胞计数增加及中性粒细胞比率升高加大了出院当日MRS评分增高的风险,并存在计量反应关系。Objective To investigate the correlation between leukocyte and MRS score of discharged patients with acute ischemic stroke(AIS). Method In a retrospective cohort study, we continuously included 1351 patients with AIS from June 1st 2011 to June 1st 2014, collecting information about epidemiology, life style and leukocyte. According to modified Rankin scale(MRS), patients were divided into two groups: MRS ≥ 3 as impaired function group and MRS ≤ 3 as contrast group. Leukocyte was divided into three groups according to(≤ 10.0×10^9·L^-1, 10.1-11.0×10^9·L^-1, 11.1-12.0×10^9·L^-1, ≥ 12.1×10^9·L^-1). Multiple Logistic regression analysis was used to assess the correlation between leukocyte and MRS score of AIS. Results Leukocyte and neutrophil ratio in the MRS ≥ 3 group were higer than that of MRS ≤ 3 group(P<0.05). Compared with the first group, the risks of impaired function in the second, third and forth group were higher, OR and 95%CI were 1.700(1.103-2.620), 2.756(1.714-4.433), 3.355(2.453-4.589) respectively after adjusting for confounding factors. There was dose-responsive correlation between leukocyte and risks of composite outcome(trend P<0.0001). Conclusion Higher leukocyte and neutrophil ratio were associated with increased risk of higher MRS score in AIS patients.

关 键 词：白细胞 中性粒细胞比率 急性缺血性脑卒中 MRS评分 

分 类 号：R743.32[医药卫生—神经病学与精神病学]