血小板相关参数与急性缺血性卒中静脉溶栓远期预后的相关性:Meta分析  

Association between platelet parameter and prognosis of acute ischemic stroke patients treated with intravenous thrombolysis:A Meta-analysis

作　　者：徐国锋 王艳[2] XU Guofeng;WANG Yan(Department of Laboratory,the Seventh Affiliated Hospital,Sun Yat-sen University,Shenzhen 518107,Guangdong,China;Center of Emergency and Disaster Medicine,the Seventh Affiliated Hospital,Sun Yat-sen University,Shenzhen 518107,Guangdong,China)

机构地区：[1]中山大学附属第七医院检验科,广东深圳518107 [2]中山大学附属第七医院急诊与灾难医学中心,广东深圳518107

出　　处：《中国现代医生》2023年第28期64-69,共6页China Modern Doctor

摘　　要：目的系统评价急性缺血性脑卒中(acute ischemic stroke,AIS)患者静脉溶栓(intravenous thrombolysis,IVT)治疗前后平均血小板体积(mean platelet volume,MPV)、血小板体积分布宽度(platelet distribution width,PDW)、血小板与淋巴细胞比值(platelet to lymphocyte ratio,PLR)、血小板与中性粒细胞比值(platelet to neutrophil ratio,PNR)与远期预后的关系。方法通过计算机检索中国知网、万方数据、重庆维普、PubMed、Web of Science数据库中关于MPV、PDW、PLR、PNR与AIS患者IVT治疗后远期预后相关性的研究文献,检索时间从建库至2023年2月,使用改良Rankin量表评估患者远期预后。使用Newcastle-Ottawa量表对文献质量进行评价,使用RevMan 5.4软件对数据进行处理。结果共14篇文献、3645例患者纳入研究。Meta分析显示:AIS患者基线MPV升高与IVT后远期预后不良呈正相关(OR=1.80,95%CI:1.27~2.53,P=0.0009),基线PDW(OR=1.16,95%CI:0.81~1.66,P=0.42)、基线PLR(OR=1.00,95%CI:0.99~1.01,P=0.91)与IVT后远期预后不良无明显相关性。IVT后24h内PLR升高(OR=1.01,95%CI:1.00~1.01,P=0.004)与远期预后不良呈正相关,PNR升高(OR=0.96,95%CI:0.94~0.97,P<0.00001)与远期预后不良呈负相关;IVT后24h内MPV(OR=0.82,95%CI:0.46~1.49,P=0.52)和PDW(OR=0.87,95%CI:0.64~1.16,P=0.34)均与远期预后不良无明显相关性。结论基线MPV升高及IVT后24h内PLR升高、PNR降低可能是AIS患者IVT后远期预后不良的预测标志物。Objective To systematically evaluate the relationship between mean platelet volume(MPV),platelet distribution width(PDW),platelet to lymphocyte ratio(PLR),platelet to neutrophil ratio(PNR)and the long-term prognosis of acute ischemic stroke(AIS)treated with intravenous thrombolysis(IVT).Methods The research literature on the correlation between MPV,PDW,PLR,PNR and the long-term prognosis of AIS patients after IVT treatment was searched by computer from CNKI,Wanfang Data,VIP,PubMed and Web of Science databases from the establishment of the library to February 2023.Modified Rankin scale was used to evaluated the long-term prognosis.The quality of literature was evaluated using the Newcastle-Ottawa scale.RevMan 5.4 software was used to analyze the data.Results A total of 14 articles and 3645 patients were included in the study.Meta-analysis revealed as follows:baseline MPV increase was correlated with poor prognosis in AIS patients after IVT(OR=1.80,95%CI:1.27-2.53,P=0.0009).Neither PDW(OR=1.16,95%CI:0.81-1.66,P=0.42)nor PLR(OR=1.00,95%CI:0.99-1.01,P=0.91)in baseline showed correlation with poor prognosis in AIS patients after IVT.Both PLR(OR=1.01,95%CI:1.00-1.01,P=0.004)increase and PNR(OR=0.96,95%CI:0.94-0.97,P<0.00001)decrease within 24 hours post-IVT were correlated with poor prognosis in AIS patients after IVT.MPV(OR=0.82,95%CI:0.46-1.49,P=0.52)and PDW(OR=0.87,95%CI:0.64-1.16,P=0.34)within 24 hours after IVT were not significantly associated with poor long-term prognosis.Conclusion The increase of MPV at baseline and the increase of PLR and decrease of PNR within 24 hours after IVT may be predictive markers of poor long-term prognosis in AIS patients after IVT.

关 键 词：平均血小板体积 血小板体积分布宽度 血小板与中性粒细胞比值 血小板与淋巴细胞比值 急性缺血性脑卒中 META分析 

分 类 号：R743[医药卫生—神经病学与精神病学]