嗜酸性粒细胞与中性粒细胞比值预测接受静脉溶栓的急性缺血性卒中患者转归  

Eosinophil-to-neutrophil ratio predicts outcomes in patients with acute ischemic stroke receiving intravenous thrombolysis

作　　者：高洁 孙波[1] 赵卫东[1] 陈向远 田向阳[1] Gao Jie;Sun Bo;Zhao Weidong;Chen Xiangyuan;Tian Xiangyang(Department of Neurology,Huai’an First Hospital Affiliated to Nanjing Medical University,Huai´an 223001,China)

机构地区：[1]南京医科大学附属淮安第一医院神经内科,淮安223001

出　　处：《国际脑血管病杂志》2023年第5期327-331,共5页International Journal of Cerebrovascular Diseases

摘　　要：目的探讨嗜酸性粒细胞与中性粒细胞比值(eosinophil to neutrophil ratio,ENR)对急性缺血性卒中(acute ischemic stroke,AIS)患者静脉溶栓后3个月时转归的预测价值。方法回顾性纳入2019年7月至2022年7月在淮安市第一人民医院神经内科接受静脉溶栓治疗的AIS患者。应用多变量logistic回归模型确定ENR与静脉溶栓后3个月时转归的相关性。利用受试者工作特征(receiver operating characteristics,ROC)曲线评估ENR水平对静脉溶栓后3个月转归不良的预测价值。结果共纳入352例接受静脉溶栓治疗的AIS患者,男性240例(68.1%),年龄(66.46±12.00)岁,中位美国国立卫生研究院卒中量表评分8分(四分位数间距5~13分)。发病后3个月时215例(61.0%)转归良好,137例(38.9%)转归不良。单变量分析显示,转归不良组中位ENR×10^(2)水平显著低于转归良好组(Z=–7.305,P<0.01)。多变量logistic回归分析显示,ENR×10^(2)较低为静脉溶栓后3个月时转归不良的独立危险因素(优势比0.619,95%置信区间0.514~0.745;P<0.01)。ROC曲线分析显示,ENR×10^(2)预测静脉溶栓后转归不良的曲线下面积为0.731(95%置信区间0.678~0.784;P<0.01),最佳截断值为0.625,其对应的敏感性和特异性分别为94%和40%。结论AIS患者静脉溶栓前ENR较低与3个月时转归不良独立相关。Objective To investigate the predicting value of eosinophil-to-neutrophil ratio(ENR)for outcomes at 3 months after intravenous thrombolysis in patients with acute ischemic stroke(AIS).Methods Patients with AIS received intravenous thrombolysis in the Department of Neurology,Huai'an First People's Hospital from July 2019 to July 2022 were included retrospectively.Multivariate logistic regression model was used to determine the independent correlation between ENR and outcomes at 3 months after intravenous thrombolysis.The receiver operating characteristics(ROC)curve was used to evaluate the predictive value of ENR levels for poor outcomes at 3 months after intravenous thrombolysis.Results A total of 352 patients with AIS receiving intravenous thrombolysis were enrolled,including 240 men(68.1%),age 66.46±12.00 years old.The median National Institutes of Health Stroke Scale score was 8(interquartile range,5-13).At 3 months after onset,215 patients(61.0%)had good outcomes,137(38.9%)had poor outcomes.Univariate analysis showed that the median ENR×10^(2) level of the poor outcome group was significantly lower than that of the good outcome group(Z=–7.305,P<0.01).Multivariate logistic regression analysis showed that lower ENR×10^(2) was an independent risk factor for poor outcomes at 3 months after intravenous thrombolysis(odds ratio 0.619,95%confidence interval 0.514-0.745;P<0.01).ROC curve analysis showed that the area under the curve for ENR×10^(2) predicting the poor outcomes after intravenous thrombolysis was 0.731(95%confidence interval 0.678-0.784;P<0.01).The optimal cutoff value was 0.625 and the corresponding sensitivity and specificity were 94%and 40%,respectively.Conclusion Lower ENR before intravenous thrombolysis in patients with AIS is independently associated with the poor outcomes at 3 months.

关 键 词：缺血性卒中 血栓溶解疗法 嗜酸性粒细胞 中性粒细胞 治疗结果 危险因素 试验预期值 

分 类 号：R743.3[医药卫生—神经病学与精神病学]