D-D、Hb、PLR、NLR与老年急性脑梗死患者非溶栓治疗后出血性转化的关系  

Relationship between D-D,Hb,PLR,NLR and Hemorrhagic Transformation after Nonthrombolytic Therapy in Elderly Patients with Acute Cerebral Infarction

作　　者：敖沛然 AO Peiran(Zunyi City Bozhou District Hospital of Traditional Chinese Medicine,Zunyi 563100,China)

机构地区：[1]遵义市播州区中医院,贵州遵义563100

出　　处：《中外医学研究》2024年第13期67-71,共5页CHINESE AND FOREIGN MEDICAL RESEARCH

摘　　要：目的:探讨D-二聚体(D-D)、血红蛋白(Hb)、血小板/淋巴细胞比值(PLR)、中性粒细胞/淋巴细胞比值(NLR)与老年急性脑梗死(ACI)患者非溶栓治疗后出血性转化(HT)的关系。方法:选取2021年5月—2023年5月遵义市播州区中医院收治的53例老年ACI非溶栓治疗后HT患者作为观察组,另选同期收治53例老年ACI非溶栓治疗后未发生HT患者作为对照组。治疗前采血测定观察组和对照组D-D、Hb、PLR、NLR水平;绘制受试者工作特征(ROC)曲线分析血清D-D、Hb、PLR、NLR单独及联合检测预测ACI非溶栓治疗后HT发生的临床价值。随访3个月,根据改良Rankin量表(mRS)评分分为预后良好组(mRS<3分,n=41)和预后不良组(mRS≥3分,n=12),比较预后良好组和预后不良组血清D-D、Hb、PLR、NLR水平。结果:观察组血清D-D、Hb水平低于对照组,NLR高于对照组,差异有统计学意义(P<0.05)。ROC曲线显示,血清D-D、Hb、NLR单独及联合检测预测ACI非溶栓治疗后HT发生的曲线下面积(AUC)为0.844、0.807、0.816、0.954,联合检测预测价值最高。预后不良组血清D-D、Hb水平低于预后良好组,NLR高于预后良好组,差异有统计学意义(P<0.05)。结论:D-D、Hb、NLR在老年ACI非溶栓后HT患者中存在明显异常表达,联合检测可提高HT预测效能,且该类指标异常表达与HT转归关系密切,还需临床高度重视,加强上述指标监测。Objective:To investigate the relationship between D-dimer(D-D),hemoglobin(Hb),platelets/lymphocytes ratio(PLR),neutrophils/lymphocytes ratio(NLR)and hemorrhagic transformation(HT)in elderly patients with acute cerebral infarction(ACI)after non-thrombolytic therapy.Method:A total of 53 elderly patients with HT after non-thrombolytic therapy of ACI treated in Zunyi City Bozhou District Hospital of Traditional Chinese Medicine from May 2021 to May 2023 were selected as the observation group,and 53 elderly patients without HT after non-thrombolytic therapy of ACI treated in the same period were selected as the control group.The levels of D-D,Hb,PLR and NLR in the observation group and the control group were measured before treatment.Receiver operating characteristic(ROC)curve was drawn to analyze the clinical value of serum D-D,Hb,PLR,NLR alone and combined detection in predicting HT after non-thrombolytic therapy with ACI.After 3 months of follow-up,according to the modified Rankin scale(mRS)score,the patients were divided into good prognosis group(mRS<3 points,n=41)and poor prognosis group(mRS≥3 points,n=12).Serum D-D,Hb,PLR and NLR levels of the good prognosis group and the poor prognosis group were compared.Result:Serum D-D and Hb levels in the observation group were lower than those in the control group,and NLR levels was higher than that in the control group,the differences were statistically significant(P<0.05).ROC curve showed that the area under the curve(AUC)of serum D-D,Hb,NLR alone and combined detection to predict HT occurrence after ACI non-thrombolytic therapy were 0.844,0.807,0.816,0.954,and the combined detection had the highest predictive value.Serum D-D and Hb levels in the poor prognosis group were lower than those in the good prognosis group,and NLR levels was higher than that in the good prognosis group,the differences were statistically significant(P<0.05).Conclusion:The abnormal expression of D-D,Hb and NLR is obvious in elderly ACI non-thrombolytic HT patients.Combined detection can improve

关 键 词：急性脑梗死 出血性转化 D-二聚体 血红蛋白 血小板/淋巴细胞 预测价值 

分 类 号：R743.33[医药卫生—神经病学与精神病学]