中性粒细胞与淋巴细胞比值、血小板与淋巴细胞比值和血小板与中性粒细胞比值对大动脉粥样硬化型进展性缺血性脑卒中的预测价值  

Predictive value of neutrophil-to-lymphocyte ratio,platelet-to-lymphocyte ratio and platelet-to-neutrophil ratio in progressive ischemic stroke of large atherosclerosis

作　　者：庞伟平 王保爱 PANG Weiping;WANG Baoai(Fenyang College,Shanxi Medical University,Shanxi Province,Fenyang 032200,China;Department of Neurology,Fenyang HospitalFenyang Hospital Affiliated to Shanxi Medical University,Shanxi Province,Fenyang 032200,China)

机构地区：[1]山西医科大学汾阳学院,山西汾阳032200 [2]山西省汾阳医院山西医科大学附属汾阳医院神经内科,山西汾阳032200

出　　处：《中国医药导报》2023年第32期93-97,共5页China Medical Herald

基　　金：山西省医学重点科研项目(2021XM41);山西省吕梁市重点研发项目(2022SHFZ13)。

摘　　要：目的探讨中性粒细胞与淋巴细胞比值(NLR)、血小板与淋巴细胞比值(PLR)和血小板与中性粒细胞比值(PNR)对大动脉粥样硬化型进展性缺血性脑卒中(PIS)的预测价值。方法回顾性收集2021年1月至12月山西省汾阳医院收治的327例大动脉粥样硬化型脑梗死患者的临床资料,根据72 h内病情是否发生进展分为PIS组(56例)和非PIS组(271例)。比较两组一般资料,探讨PIS的影响因素,并评估NLR、PLR和PNR对PIS的预测价值。结果PIS组入院收缩压、舒张压,美国国立卫生研究院卒中量表(NIHSS)评分,白细胞计数,中性粒细胞计数,NLR,PLR高于非PIS组,淋巴细胞计数和PNR低于非PIS组,差异有统计学意义(P<0.05)。NLR(OR=1.150,95%CI:1.048~1.261,P=0.003)、PLR(OR=1.006,95%CI:1.002~1.009,P=0.002)和PNR(OR=0.978,95%CI:0.958~0.997,P=0.024)是PIS的独立影响因素。NLR预测PIS的受试者操作特征曲线(ROC)曲线下面积为0.707(95%CI:0.642~0.772,P<0.001),最佳截断值为3.14,灵敏度为82.1%,特异度为61.6%;PLR预测PIS的ROC曲线下面积为0.662(95%CI:0.589~0.736,P<0.001),最佳截断值为138.50,灵敏度为73.2%,特异度为57.2%;PNR预测PIS的ROC曲线下面积为0.604(95%CI:0.530~0.677,P=0.015),最佳截断值为44.28,灵敏度为64.3%,特异度为59.4%。结论NLR、PLR和PNR是PIS的独立影响因素,均对大动脉粥样硬化型PIS有预测价值。Objective To investigate the predictive value of neutrophil-to-lymphocyte ratio(NLR),platelet-to-lymphocyte ratio(PLR)and platelet-to-neutrophil ratio(PNR)in the progressive ischemic(PIS)stroke of large atherosclerosis.Methods Clinical data of 327 patients with large atherosclerotic cerebral infarction admitted to Fenyang Hospital of Shanxi Province from January 2021 to December 2021 were retrospectively collected.They were divided into PIS group(56 cases)and non-PIS group(271 cases)according to whether the disease progressed within 72 hours.Two sets of general data were compared and the influencing factors of PIS were explored and the predictive value of NLR,PLR,and PNR for PIS were evaluated.Results Admission systolic blood pressure,admission diastolic blood pressure,admission National Institutes of Health stroke scale(NIHSS)score,white blood cell count,neutrophil count,NLR,and PLR in PIS group were higher than those in non-PIS group,and lymphocyte count and PNR were lower than those in non-PIS group,with statistical significances(P<0.05).NLR(OR=1.150,95%CI:1.048-1.261,P=0.003),PLR(OR=1.006,95%CI:1.002-1.009,P=0.002),and PNR(OR=0.978,95%CI:0.958-0.997,P=0.024)were independent influencing factors of PIS.NLR predicted the area under receiver operating characteristic(ROC)curve of PIS was 0.707(95%CI:0.642-0.772,P<0.001),the optimal cutoff value was 3.14,the sensitivity was 82.1%,and the specificity was 61.6%.The area under curve of ROC PLR predicted PIS was 0.662(95%CI:0.589-0.736,P<0.001),the optimal cutoff value was 138.50,the sensitivity was 73.2%,and the specificity was 57.2%.The area under ROC curve of PNR predicted PIS was 0.604(95%CI:0.530-0.677,P=0.015),the best cutoff value was 44.28,the sensitivity was 64.3%,and the specificity was 59.4%.Conclusion NLR,PLR,and PNR are independent influencing factors of PIS,all of which have predictive value for progressive stroke of large atherosclerosis.

关 键 词：进展性脑卒中 中性粒与淋巴细胞比值 血小板与淋巴细胞比值 血小板与中性粒细胞比值 

分 类 号：R743.3[医药卫生—神经病学与精神病学]