血液检测值对首发缺血性卒中患者住院时长的预测作用  

Blood Tests predict length of stay in patients with first-ever ischemic stroke

作　　者：杨新雷 伍鸿鹄 刘松 易云[1] 周伟[2] 葛艳秋 易应萍[4] YANG Xin-lei;WU Hong-hu;LIU Song;YI Yun;ZHOU Wei;GE Yan-qiu;YI Ying-ping(Biobank Center,Second Affiliated Hospital of Nanchang University,Nanchang 330006,China;不详)

机构地区：[1]南昌大学第二附属医院生物样本资源中心,江西南昌330006 [2]南昌大学第二附属医院心内科,江西南昌330006 [3]南昌大学医学部公共卫生学院,江西南昌330006 [4]南昌大学第二附属医院信息处,江西南昌330006

出　　处：《现代预防医学》2020年第6期1133-1137,共5页Modern Preventive Medicine

基　　金：国家重点研发计划(2018YFC1312902);江西省科技厅科技创新平台(20171BCD40024);江西省科技厅重大项目(20171BBH80025)。

摘　　要：目的评价血液检测值对首发缺血性脑卒中患者住院时长预测作用。方法回顾性收集2009年1月-2017年7月在南昌大学第二附属医院收治的5 340例首发缺血性脑卒中患者的临床资料,研究入院24 h内的血液检测值对住院时长的预测作用。结果首发缺血性卒中患者5 340例(男性3 351例,占比62.75%),平均年龄(65.22±12.24)岁,患者住院时长中位值为10 d。多因素分析结果显示糖化血红蛋白、低密度脂蛋白、总胆红素、葡萄糖、医保患者、NLR是住院时长的影响因素,其OR值分别为1.096、1.129、0.983、1.093、1.542、1.673(均P<0.05)。采用受试者工作特征ROC曲线评估NLR的最佳预测临界值是2.98,对于住院时长具有良好的预测性。NLR、Hb A1c、LDL、Glu和TBIL 5因素联合预测结果优于单因素预测结果,AUC为0.623(95%CI:0.608~0.638),预测效果较好。结论首发缺血性卒中患者糖化血红蛋白、低密脂蛋白、总胆红素、葡萄糖、NLR与住院时长关系密切,有一定的预测价值,是简单、廉价、易得的生物标志物,可作为评估缺血性卒中住院时长的临床实用指标,具有较大的临床应用价值。Objective To evaluate the effect of blood tests on the length of stay in patients with first-ever ischemic stroke.Methods Clinical data of 5,340 patients with first-ever ischemic stroke admitted to the Second Affiliated Hospital of Nanchang University from January 2009 to July 2017 were retrospectively collected to study the predictive effect of blood tests and neutral/lymphocyte ratio(NRL)on length of stay within 24 hours after admission.Results Total 5,840 patients(3,351 males,accounting for 62.75%)were newly diagnosed with ischemic stroke,with an average age of 65.22±12.24.The median length of stay was 10 days.Multivariate analysis showed that glycosylated hemoglobin,low-density lipoprotein,total bilirubin,glucose,medical insurance,and NLR were the influencing factors of length of hospitalization,with OR values of 1.096,1.129,0.983,1.093,1.542,and 1.673(P<0.05),respectively.The ROC analysis demonstrated that the border value of NLR was 2.98,which was a good predictor for the length of stay.The combined prediction results of NLR,HbA1c,LDL,Glu and TBIL were better than the single-factor,and the AUC was 0.623(95%CI 0.608-0.638),indicating a good prediction effect.Conclusion The glycosylated hemoglobin,total bilirubin,glucose and NLR in the first-ever ischemic stroke patients are closely related to the length of stay.They are simple,inexpensive,and readily available biomarkers and may serve as clinically practical indicators for assessing the length of stay in ischemic stroke patients.Early treatment can improve prognosis,and have great clinical application value.

关 键 词：首发缺血性脑卒中 血液检测值 中性淋巴细胞比 住院时长 

分 类 号：R743.3[医药卫生—神经病学与精神病学]