NLR与缺血性脑卒中患者预后关系研究  

Neutrophil to Lymphocyte Ratio Predicts Poor Prognosis for Acute Ischemic Stroke

作　　者：马炜[1] 朱俊[1] 徐健[1] 陈明坤[1] 孙毓锴 任含笑 高谦[1] 李闻捷[1] 

机构地区：[1]第二军医大学附属上海长海医院实验诊断科

出　　处：《现代检验医学杂志》2016年第4期139-142,共4页Journal of Modern Laboratory Medicine

摘　　要：目的 探讨缺血性脑卒中患者中性粒细胞与淋巴细胞比例（NLR）与脑卒中的发生及预后的相关性。方法 选取2012年1月-2014年8月在长海医院住院就诊并首次确诊为缺血性脑卒中的患者208例,通过出院mRS评分标准将其分为：0-2分组179例,3-6分组29例。测定患者血清中血常规、尿酸、凝血等指标,研究这些指标与卒中预后的相关性。结果 mRS分型中NLR在3-6分组（3.69±3.02）中明显高于0-2分组（2.42±1.21）,差异均有统计学意义（P=0.037）; 不同脑卒中分型OCSP分型之间NLR存在差异（P=0.02）,而TOAST各分型之间NLR的值无差异（P=0.489）; NLR与mRS分型之间存在正相关,差异具有统计学意义（P〈0.01）; ROC曲线：NLR曲线下面积最大为0.690,cut-off值为2.384,灵敏度76%,特异度57%。结论 NLR可以区分OCSP分型中后循环性梗死与其他梗死类型,是一种缺血性脑卒中预后的预测因子。Objective To investigate the association between index of blood and occurrence or prognosis of the disease in pa- tients with ischemic stroke. Methods Our study included 208 patients who were hospitalized in Changhai Hospital, from January 2012 to August 2014 and were confirmed ischemic stroke for the first time. Divided the patients into 2 groups using modified Rankin Scale （mRS） score： 179 in 0-2 group and 29 in 3-6 group. Afterwards examined blood routine and meas-ured the concentration of uric acid,thrombin and other parameters in plasma of these patients to explore the correlation between these plasma factors and prognosis of the disease. Results Compared to 0 - 2 group, patients in 3 - 6 group possessed markedly higher neutrophilly-mphocyte ratio （NLR） and the differences were statistically significant （P〈0.05）. Among different types of stoke in OCSP classification there were differences in NLR （P=0.02）,but as for TOAST classification there was no statistical significance （P=0. 489）. NLR was positively correlated with mRS grouping and the differences were statistically significant （P〈0.01）. A cut-off value of 2. 384 for the NLR yielded 76% sensitivity and 57% specificity in pre- dicting prognosis. Conclusion NLR has differences between OCSP subtype,indicating itself a predictive factor for the prognosis of ischemic stroke.

关 键 词：缺血性脑卒中 改良Rankin评分 中性粒与淋巴细胞比率 

分 类 号：R743.3[医药卫生—神经病学与精神病学] R446.11[医药卫生—临床医学]