探讨NLR、PLR、hs-CRP、Hb、D-D与ACI非溶栓治疗后出血性转化的相关性分析  

Correlation analysis of NLR,PLR,hs-CRP,Hb,D-D and hemorrhagic transformation after non thrombolytic therapyin acute cerebral infarction

作　　者：张玫娜[1] 郭志鹏[1] 曹扬[1] Zhang Meina;Guo Zhipeng;Cao Yang(Department of Labiratory,Jilin in University,Changchun 130031,China)

机构地区：[1]吉林大学第一医院,长春130031

出　　处：《脑与神经疾病杂志》2024年第1期26-30,共5页Journal of Brain and Nervous Diseases

摘　　要：目的 探讨急性脑梗死患者(ACI)非溶栓治疗前血清中性粒细胞与淋巴细胞比值(NLR)、血小板与淋巴细胞比值(PLR)、超敏C反应蛋白(hs-CRP)、血红蛋白(Hb)、D-二聚体(D-D)与治疗后出血性转化(HT)的相关性,以期为临床预防ACI非溶栓治疗后发生提供指导依据。方法 本研究病历组(设为转化组)共纳入80例样本,选取自2015年1月至2019年12月在吉林大学第一医院检验科接受非溶栓治疗后并出现HT的ACI患者,根据HT严重程度等级化分1级、2级、3级、4级,各严重程度患者分别为27例、22例、18例、13例。选取50例在接受非溶栓治疗后未出现HT的ACI患者作为对照(非转化组)。比较各组的血清NLR、PLR、hs-CRP、Hb、D-D表达水平差异,并通过Spearman秩相关检验分析NLR、PLR、hs-CRP、Hb、D-D与HT严重程度的相关性。并采用ROC曲线分析NLR、PLR、hsCRP、Hb、D-D对ACI患者HT的预测作用。结果 转化组的血清NLR、PLR、hs-CRP、D-D表达水平均高于非转化组,Hb的表达水平低于非转化组(均P<0.05)。1级、2级、3级、4级患者的血清NLR、PLR、hs-CRP、D-D表达水平依次上升,Hb表达水平依次降低,差异有统计学意义(P<0.05),且组间两两比较,差异有统计学意义(P<0.05)。ACI非溶栓治疗后HT严重程度与血清NLR、PLR、hs-CRP、D-D均呈正相关(r值分别为:0.729、0.692、0.601、0.578,均P<0.05),与Hb呈负相关(r值为:-0.678,P<0.05)。ROC曲线分析显示,NLR的AUC值为0.896[95%CI(0.737~0.962)]、PLR的AUC值为0.775 [95%CI(0.626~0.917)]、hs-CRP的AUC值为0.840 [95%CI(0.712~0.948)]、Hb的AUC值为0.782 [95%CI(0.493~0.914)]、D-D的AUC值为0.725 [95%CI(0.403~0.852)]。结论 ACI患者的NLR值、PLR值、hs-CRP、Hb、D-D表达水平与其在非溶栓治疗后发生HT存在相关性,临床上可将这些指标作为预测HT风险。Objective To investigate the correlation between serum neutrophil to lymphocyte ratio(NLR),platelet to lymphocyte ratio(PLR),hypersensitive C-reactive protein(hs-CRP),hemoglobin(Hb),D-dimer(D-D)and post treatment hemorrhagic transformation(HT)in patients with acute cerebral infarction(ACI)before non thrombolytic therapy,in order to provide guidance for the clinical prevention of hemorrhagic transformation after non thrombolytic therapy in ACI.Methods In this study,a total of 80 samples were included in the case group(set as the conversion group).ACI patients who underwent non thrombolytic treatment in the Laboratory of Jilin University First Hospital from January 2015 to December 2019 and developed HT were selected.According to the severity level of HT,they were classified into levels 1,2,3,and 4,with 27,22,18 and 13 patients of each severity level.50 ACI patients who did not experience HT after receiving non thrombolytic therapy were selected as the control group(non conversion group).Compare the differences in serum NLR,PLR,hs-CRP,Hb,D-D expression levels among each group,and analyze the correlation between NLR,PLR,hs-CRP,Hb,D-D and the severity of HT using Spearman rank correlation test.And ROC curves were used to analyze the predictive effects of NLR,PLR,hs-CRP,Hb,D-D on HT in ACI patients.

关 键 词：NLR PLR HS-CRP HB D-D 急性脑梗死 出血性转化 

分 类 号：R743.32[医药卫生—神经病学与精神病学]