中性粒细胞/淋巴细胞比值对穿支动脉病变型脑梗死预后的影响  

Effect of neutrophil/lymphocyte ratio on prognosis of perforating artery disease

作　　者：宋玲华 楼晓莉 姜雅斯 杨丽慧[1] 郭四平[1] 彭浩[2] 郝永岗[1] SONG Linghua;LOU Xiaoli;JIANG Yasi;YANG Lihui;GUO Siping;PENG Hao;HAO Yonggang(Department of Neurology,Dushu Lake Affiliated Hospital of Soochow University,Soochow 231523,Jiangsu,China;Department of Epidemiology,School of Public Health,Medical College of Soochow University,Soochow 231523,Jiangsu,China)

机构地区：[1]苏州大学附属独墅湖医院(苏州市独墅湖医院)神经内科,苏州231523 [2]苏州大学公共卫生学院流行病学教研室,苏州231523

出　　处：《医学研究与战创伤救治》2024年第1期37-41,共5页Journal of Medical Research & Combat Trauma Care

基　　金：苏州市科技计划项目(SZM2023017)。

摘　　要：目的研究影响穿支动脉病变型脑梗死(PAD)不良预后的危险因素。方法回顾性分析2021年9月至2023年5月在苏州大学附属独墅湖医院神经内科住院的174例急性PAD患者。根据90 d改良后Rankin评分(mRS)0~2分为预后良好组,3~6分为预后不良组;使用logistic回归模型分析影响PAD患者预后的危险因素。根据病变部位供血动脉所起源颅内大动脉分为前循环(n=101)、后循环组(n=73),分析前循环、后循环与预后不良的相关性。结果多因素logistics回归显示年龄增长(OR=1.071,95%CI:1.012~1.133)、入院NIHSS评分升高(OR=2.764,95%CI:1.868~4.089)、患糖尿病(OR=3.301,95%CI:1.009~10.793)、中性粒细胞/淋巴细胞比值(NLR)升高(OR=2.601,95%CI:1.150~4.482)是PAD患者预后不良的危险因素(P<0.05)。ROC曲线结果提示NIHSS评分以及NLR升高相较于年龄增高以及患糖尿病病史预测PAD患者不良预后的AUC更大,总体敏感性及特异性更高,提示其预测不良预后的价值可能更高。前循环组中LYM下降及NLR上升与预后不良显著相关(P<0.05),后循环组中NE上升、LYM下降以及NLR上升均与预后不良显著相关(P<0.05)。结论基线NLR及NIHSS评分升高,高龄及糖尿病病史可能是PAD患者不良预后的独立危险因素,NLR可作为预测PAD预后的潜在生物学指标值。Objective To investigate the risk factors affecting the poor prognosis of perforating artery disease(PAD).Methods 174 patients with acute PAD admitted to the Department of Neurology,Dushu Lake Hospital Affiliated to Soochow University from September 2021 to May 2023 were retrospectively analyzed.According to the improved Rankin score(mRS)after 90 days,0-2 scores were good prognosis group,3-6 scores were poor prognosis group;logistic regression model was used to analyze the risk factors affecting the prognosis of patients with PAD.According to the intracranial arteries from which the blood supply arteries originated,the patients were divided into anterior circulation group(n=101)and posterior circulation group(n=73).The correlation between anterior and posterior circulation and poor prognosis was analyzed.Results Multi-factor logistic regression showed that the increase of age(OR=1.071,95%CI:1.012-1.133),the increase of NIHSS score on admission(OR=2.764,95%CI:1.868-4.089),diabetes history(OR=3.301,95%CI:1.009-10.793)and increased neutrophil/lymphocyte ratio(NLR)(OR=2.601,95%CI:1.150-4.482)were risk factors for poor prognosis in PAD patients(P<0.05).ROC curve results suggested that compared with increasing age and diabetes history,the increase of NIHSS score and NLR had greater AUC in predicting poor prognosis in PAD patients,and the overall sensitivity and specificity were higher,suggesting that their value in predicting poor prognosis might be higher.The decrease of LYM and the increase of NLR in the anterior circulation group were significantly correlated with poor prognosis(P<0.05),and the increase of NE,the decrease of LYM and the increase of NLR in the posterior circulation group were significantly correlated with poor prognosis(P<0.05).Conclusion The increase of baseline NLR and NIHSS scores,advanced age and diabetes history may be independent risk factors for poor prognosis of PAD patients,and NLR can be used as a potential biological index to predict the prognosis of PAD patients.

关 键 词：穿支动脉供血区梗死 中性粒细胞/淋巴细胞比值 CISS分型 

分 类 号：R743[医药卫生—神经病学与精神病学]