外周血白细胞计数及中性粒细胞与淋巴细胞比值与急性脑梗死患者预后关系的研究  

Study on the Relationship Between Peripheral Blood Leukocyte Count,NLR,and Prognosis in Patients with Acute Cerebral Infarction

作　　者：李国花[1] 苏东兴 LI Guohua;SU Dongxing(Jinjiang City Hospital(Shanghai Sixth People's Hospital,Fujian Hospital)Inspection Division,Jinjiang 362200,China)

机构地区：[1]晋江市医院(上海市第六人民医院福建医院)检验科,福建晋江362200

出　　处：《中华灾害救援医学》2024年第9期1049-1051,共3页Chinese Journal of Disaster Medicine

摘　　要：目的探索单个及联合外周免疫细胞在评估急性脑梗死患者预后中的价值。方法纳入2022年1月到2023年6月于晋江市医院(上海市第六人民医院福建医院)进行救治的100例急性脑梗死患者。采用单因素初步筛选急性脑梗死患者预后相关的潜在因素,以COX模型筛选患者预后的独立危险因素,用ROC曲线分析相关因素在评估患者预后中的预测价值。结果100例患者中,74例患者预后良好,26例患者预后不良。单因素分析显示两组患者中性粒细胞、嗜酸性粒细胞、淋巴细胞、中性粒细胞与淋巴细胞比值(Neutrophil to Lymphocyte Ratio,NLR)、C-反应蛋白(C-reactive protein,CRP)、平均脑梗死体积有显著差异(P<0.001)。COX模型分析显示中性粒细胞水平增加、嗜酸性粒细胞水平降低、NLR水平增加是脑梗死预后的独立危险因素。ROC分析结果显示,外周血中性粒细胞计数、嗜酸性粒细胞计数、NLR与三者联合对急性脑梗死不良预后的预测,其AUC分别为0.707、0.716、0.803、0.882。结论外周血免疫细胞中中性粒细胞水平增加、嗜酸性粒细胞水平降低、NLR水平增加是评估急性脑梗死患者预后的独立危险因素,三者联合可提高预测的准确性。Objective To explore the value of individual and combined peripheral immune cells in assessing the prognosis of patients with acute cerebral infarction.Methods This study included 100 patients with acute cerebral infarction who were treated at Jinjiang Hospital(Fujian Hospital of Shanghai Sixth People's Hospital)from January 2022 to June 2023.Univariate analysis was employed to preliminarily screen for potential factors related to the prognosis of acute cerebral infarction.The COX model was used to identify independent risk factors for prognosis,and ROC curve analysis was conducted to evaluate the predictive value of these factors.Results Among the 100 patients,74 patients had a favorable prognosis while 26 patients had an unfavorable prognosis.Univariate analysis revealed significant differences in neutrophils,eosinophils,lymphocytes,neutrophil-to-lymphocyte ratio(NLR),C-reactive protein(CRP),and average infarct volume between the two groups(P<0.001).COX model analysis indicated that increased neutrophil levels,decreased eosinophil levels,and increased NLR are independent risk factors for the prognosis of cerebral infarction.The results of the ROC analysis showed that the AUC for predicting poor prognosis of acute cerebral infarction based on peripheral blood neutrophil count,eosinophil count,NLR,and the combination of the three were 0.707,0.716,0.803,and 0.882,respectively.Conclusion Increased levels of neutrophils,decreased levels of eosinophils,and increased NLR in peripheral blood are independent risk factors for assessing the prognosis of patients with acute cerebral infarction.The combination of these three factors can enhance the accuracy of prognosis prediction.

关 键 词：脑梗死 预后 危险因素 诊断价值 

分 类 号：R743.3[医药卫生—神经病学与精神病学]