血小板/淋巴细胞比值、中性粒细胞/淋巴细胞比值与急性脑梗死患者溶栓预后相关性分析  

Correlation analysis between platelet-to-lymphocyte ratio,neutrophil-to-lymphocyte ratio and prognosis of patients with acute cerebral infarction after thrombolysis

作　　者：张科[1] 谭红霞[1] 张树堂[1] 胡建川 钟璨野 ZHANG Ke;TAN Hong-xia;ZHANG Shu-tang;HU Jian-chuan;ZHONG Can-ye(Division of General Medicine,Chongqing Fuling Central Hospital,Chongqing 408000,China)

机构地区：[1]重庆市涪陵中心医院全科医学科,重庆408000

出　　处：《创伤与急危重病医学》2020年第5期330-334,共5页Trauma and Critical Care Medicine

基　　金：重庆市科技计划项目(2014ABB2105)。

摘　　要：目的探讨血小板/淋巴细胞比值(PLR)、中性粒细胞/淋巴细胞比值(NLR)与急性脑梗死溶栓后患者预后的相关性。方法选取自2013年1月至2018年1月重庆市涪陵中心医院收治的208例急性脑梗死溶栓治疗患者为研究对象。根据预后情况将患者分为预后不良组(n=86)和预后良好组(n=122),分别检测两组患者的PLR、NLR值;采用受试者工作特征(ROC)曲线,分析PLR、NLR对急性脑梗死溶栓后患者不良预后的预测评估价值;应用多因素Logistic回归分析急性脑梗死溶栓后患者不良预后的危险因素。结果脑梗死患者溶栓后PLR、NLR值均低于溶栓前,差异有统计学意义(P<0.05)。Pearson相关性分析结果显示,PLR与急性脑梗死患者溶栓后的mRS呈负相关(P=0.011),与NIHSS评分呈正相关(P=0.001);NLR与急性脑梗死患者溶栓后的mRS呈负相关(P=0.001)、与NIHSS评分呈正相关(P=0.001)。ROC曲线结果示,PLR曲线下面积为0.791(95%可信区间0.691~0.891,P=0),最佳预测值为130.50,其敏感度和特异度分别为0.766和0.676;NLR曲线下面积为0.710(95%可信区间0.596~0.823,P=0.001),最佳预测值为2.83,其敏感度和特异度分别为0.681和0.735。预后良好组患者的病死率低于预后不良组,PLR>130.50患者的病死率高于PLR≤130.50患者,NLR>2.83患者的病死率高于NLR≤2.83患者,差异均有统计学意义(P<0.05)。logistic回归分析结果显示,患者NIHSS评分、发病至溶栓时间、PLR、NLR是影响溶栓治疗的急性脑梗死患者不良预后的独立危险因素。结论PLR、NLR值升高是影响急性脑梗死患者不良预后的独立危险因素;PLR、NLR对溶栓治疗的急性脑梗死患者的预后有一定评估价值。Objective To investigate the correlation analysis between platelet-to-lymphocyte ratio(PLR),neutrophil-to-lymphocyte ratio(NLR)and prognosis of patients with acute cerebral infarction after thrombolysis.Methods A retrospective study was performed on 208 cases of patients with acute cerebral infarction who were admitted and performed thrombolysis from January 2013 to January 2018.According to the prognosis,patients were divided into the group with poor prognosis(n=86)and the group with good prognosis(n=122).The PLR and NLR values of the two groups were measured,respectively.The receiver operating characteristic(ROC)curve was used to analyze the prognostic value of PLR and NLR in patients with acute cerebral infarction after thrombolysis.Multivariate logistic regression was used to analyze the risk factors for poor prognosis in patients with acute cerebral infarction after thrombolysis.Results The PLR and NLR values of patients with cerebral infarction after thrombolysis were lower than those before thrombolysis,respectively,with statistically significant differences(P<0.05).Pearson correlation analysis showed that PLR was negatively correlated with mRS after thrombolysis in patients with acute cerebral infarction(P=0.011),and positively correlated with NIHSS score(P=0.001).NLR was negatively correlated with mRS after thrombolysis in patients with acute cerebral infarction(P=0.001)and positively correlated with NIHSS score(P=0.001).ROC curve results showed that the area under the PLR curve was 0.791(95%CI:0.691~0.891,P=0),and the best predictive value was 130.50.The sensitivity and specificity were 0.766 and 0.676,respectively.The area under the NLR curve was 0.710(95%CI:0.596~0.823,P=0.001),the best predictive value was 2.83,and the sensitivity and specificity were 0.681 and 0.735,respectively.The mortality of patients in good prognosis group was lower than that of patients in poor prognosis group,PLR>130.50 was higher than that of patients with PLR≤130.50,and NLR>2.83 was higher than that of patients with NLR�

关 键 词：血小板 中性粒细胞 淋巴细胞 急性脑梗死 溶栓 

分 类 号：R743.3[医药卫生—神经病学与精神病学]