血小板参数和中性粒细胞与淋巴细胞比值对急性缺血性脑卒中患者早期诊断及溶栓患者短期预后的评估  

Influence of platelet parameters and neutrophil/lymphocyte ratio on short-term prognosis of acute ischemic stroke patients with thrombolysis

作　　者：张洁[1] 黄云苑 宋凤卿[1] 刘思齐[1] 温立强[1] 蒋龙元[1] Zhang Jie;Huang Yun-yuan;Song Feng-qing;Liu Si-qi;Wen Li-qiang;Jiang Long-yuan(Department of Emergency,San Yat-sen Memorial Hospital,Zhongshan University,Guangzhou 510120,China)

机构地区：[1]中山大学孙逸仙纪念医院急诊科,广东广州510120

出　　处：《中国急救医学》2021年第11期949-953,共5页Chinese Journal of Critical Care Medicine

摘　　要：目的探讨血小板参数和中性粒细胞与淋巴细胞比值(NLR)对急性缺血性脑卒中(AIS)患者病情和预后评估的效果。方法回顾性分析2019年1月至2020年11月在我院急诊科就诊的AIS患者184例,根据是否使用阿替普酶溶栓治疗分为溶栓组(n=91)和未溶栓组(n=93),选择健康体检者84例作为正常组;溶栓患者根据入院和溶栓后NIHSS评分好转率分为短期好转组(n=58)和短期未好转组(n=33)。比较各组血小板参数和NLR;并采用多重线性回归来确定血小板参数、中性粒细胞与淋巴细胞的百分比与溶栓患者短期预后的相关性。结果溶栓组和未溶栓组的血小板平均体积(MPV)、血小板体积分布宽度(PDW)、大血小板比率(P-LCR)、血小板比积(PCT)及NLR较正常组明显升高(P<0.05);但溶栓组与未溶栓组比较MPV、PDW、PLCR差异无统计学意义(P>0.05);短期好转组与未好转组比较,MPV、PDW、P-LCR和PCT差异均无统计学意义(P>0.05),而NLR差异有统计学意义(P<0.05);多重线性回归分析NLR与溶栓患者的预后有明显相关性,NLR越高短期预后越差。结论血小板参数和NLR对AIS患者早期诊断有一定的临床参考价值,NLR可预测溶栓患者的短期预后。Objective To evaluate the diagnostic and prognostic value of platelet-related parameters,neutrophil/lymphocyte ratio(NLR)in acute ischemic stroke(AIS).Methods Retrospective analysis were investigated in 91 patients with AIS treated with alteplase thrombolysis in emergency department of Sun Yat-sen Memorial Hospital from January 2019 to November 2020 as the thrombolytic group,84 patients with health examination as the normal group,93 patients with AIS but without thrombolytic therapy as the non-thrombolytic group.According to the improvement rate of NIHSS score,the patients in the thrombolytic group were divided into short-term improved group(58 patients)and short-term unimproved group(33 patients).The differences of platelet-related parameters among the three groups and between short-term improved group and short-term unimproved group were analyzed.Multiple linear regression analysis was used to determine the correlation of platelet parameters and NLR with the short-term prognosis of thrombolytic patients.Results Mean platelet volume(MPV),platelet distribution width(PDW),platelet-large cell ratio(P-LCR),platelet hematocrit(PCT),as well as NLR were significantly higher in the thrombolytic group and non-thrombolytic group than those in the normal group(P<0.05).There were no significant differences in MPV,PDW,P-LCR between the thrombolytic group and non-thrombolytic group(P>0.05).NLR,but not MPV,PDW,P-LCR and PCT,was associated with good short-term outcome for AIS patients,who received thrombolytic therapy.Multiple linear regression analysis showed that NLR was significantly correlated with the prognosis of thrombolytic patients.The higher the NLR was,the worse the short-term prognosis was.Conclusions Platelet-related parameters and NLR play a significant role in clinical diagnosis of AIS.In addition,NLR had predictive value for good short-term outcome in AIS patients,who received thrombolytic therapy.

关 键 词：血小板参数 中性粒细胞与淋巴细胞比值(NLR) 溶栓 急性缺血性脑卒中(AIS) 美国国立卫生研究院神经功能缺损评分(NIHSS) 

分 类 号：R743.3[医药卫生—神经病学与精神病学]