基于不同中性粒细胞与淋巴细胞比值探讨机械取栓术后首次CT征象与患者预后的关系  

Relationship between the first CT signs after mechanical thrombectomy and prognosis of patients based on different neutrophil-lymphocyte ratios

作　　者：陈科春 吴秋义[1] 李建[2] 周寅[1] 徐周 Chen Kechun;Wu Qiuyi;Li Jian;Zhou Yin;Xu Zhou(Department of Neurology,The First People's Hospital of Zhangjiagang City,Zhangjiagang 215600,China;Department of Neurosurgery,The First People's Hospital of Zhangjiagang City,Zhangjiagang 215600,China)

机构地区：[1]张家港市第一人民医院神经内科,江苏张家港215600 [2]张家港市第一人民医院神经外科,江苏张家港215600

出　　处：《中华脑科疾病与康复杂志（电子版）》2023年第4期215-221,共7页Chinese Journal of Brain Diseases and Rehabilitation（Electronic Edition）

摘　　要：目的研究在不同中性粒细胞与淋巴细胞比值(NLR)下机械取栓术后首次CT征像与患者预后的关系。方法回顾性分析张家港市第一人民医院神经内科自2017年1月至2021年12月进行机械取栓治疗的201例患者的临床资料。根据术后首次CT征像分为高密度影组和无高密度影组;同时按照术前NLR数值分为低NLR组和高NLR组,然后根据术后首次CT有无高密度影进行亚组分析。比较各组患者的90 d预后良好率、症状性颅内出血发生率、90 d内死亡率等临床结局。结果术后CT有高密度影的患者(高密度影组)100例,余101例患者纳入无高密度影组。无高密度影组患者的症状性颅内出血率低于高密度影组(OR=0.207,95%CI:0.082~0.521,P<0.001),但2组的90 d预后良好率和死亡率比较,差异无统计学意义(P>0.05)。低NLR组患者137例,CT无、有高密度影亚组的90 d预后良好率和死亡率、症状性颅内出血率比较,差异无统计学意义(P>0.05)。高NLR组患者64例,与CT有高密度影亚组比较,CT无高密度影亚组的90 d良好预后率高(OR=3.515,95%CI:1.051~11.748,P=0.041),90 d内死亡率低(OR=0.262,95%CI:0.071~0.977,P=0.046),症状性颅内出血率低(OR=0.132,95%CI:0.026~0.679,P=0.015)。结论机械取栓术后首次CT有高密度影较无高密度影有更高的症状性颅内出血率,但对预后无显著影响。高NLR患者取栓术后首次CT出现高密度影可影响其临床预后,而低NLR患者的术后CT征像对预后的影响不显著。Objective To study the relationship between the first CT signs after mechanical thrombectomy and prognosis of patients based on different neutrophil-lymphocyte ratios(NLR).Methods The clinical data of 201 patients who underwent mechanical thrombectomy from January 2017 to December 2021 in the Neurology Department of The First People's Hospital of Zhangjiagang City were retrospectively analyzed.According to the first postoperative CT imaging,they were divided into high-density CT imaging group and non high-density CT imaging group;At the same time,they were divided into low NLR group and high NLR group according to preoperative NLR values,and then subgroup analysis was conducted based on whether there were high-density shadows on the first postoperative CT.The 90-day good prognosis rate,the incidence of symptomatic intracranial hemorrhage and the mortality rate within 90 d were compared among the subgroups.Results There were 100 patients with high-density CT imaging after operation(high-density CT imaging group),and the remaining 101 patients were included in the non high-density CT imaging group.The rate of symptomatic intracranial hemorrhage in the non high-density CT imaging group was lower than that in high-density CT imaging group(OR=0.207,95%CI:0.082-0.521,P<0.001),but there was no statistically significant difference in 90-day good prognosis and mortality between the two groups(P>0.05).There were 137 patients in the low NLR group.There was no significant difference in the rate of 90-day good prognosis,mortality and symptomatic intracranial hemorrhage at 90 d between the subgroup without and with high-density CT imaging(P>0.05).There were 64 patients in the high NLR group.Compared with the subgroup with high-density CT imaging,the subgroup without high-density CT imaging had a higher 90-day good prognosis(OR=3.515,95%CI:1.051-11.748,P=0.041),and a lower 90-day mortality(OR=0.262,95%CI:0.071-0.977,P=0.046),symptomatic intracranial hemorrhage rate was low(OR=0.132,95%CI:0.026-0.679,P=0.015).Conclusion After me

关 键 词：缺血性卒中 机械取栓 CT高密度影 中性粒细胞与淋巴细胞比值 预后 

分 类 号：R742[医药卫生—神经病学与精神病学]