急性脑梗死早期外周血WBC、PLT、PMA变化及其临床意义探讨  

Changes in Early Peripheral Blood WBC,PLT,and PMA in Acute Cerebral Infarction and Their Clinical Significance

作　　者：冯雪 时芳芳 FENG Xue;SHI Fangfang(Department of Laboratory,Zhengzhou Jinshui District General Hospital,Zhengzhou Henan 450000,China;Department of Medical Laboratory,Zhengzhou Jinshui District General Hospital,Zhengzhou Henan 450000,China)

机构地区：[1]郑州市金水区总医院检验科,河南郑州450000 [2]郑州市金水区总医院医学检验科,河南郑州450000

出　　处：《临床研究》2025年第3期139-143,共5页Clinical Research

摘　　要：目的检测急性脑梗死(ACI)患者早期外周血白细胞计数(WBC)、血小板计数(PLT)、血小板-单核细胞聚集物(PMA)变化,并分析其临床意义。方法选取2020年9月至2023年3月郑州市金水区总医院收治的148例ACI患者作为疾病组,另择取同一时期于本院接受体检的148例健康志愿者作为对照组,比较疾病组、对照组外周血WBC、PLT、PMA水平。依据疾病组的预后状况,把其划分成预后良好组与预后不良组,比较两组入院后第1 d、3 d、7 d的外周血WBC、PLT、PMA水平及一般资料;运用多因素Logistic回归分析法对致使ACI患者预后不良的影响因素进行剖析,并绘制受试者工作特征(ROC)曲线分析外周血WBC、PLT、PMA水平对ACI患者预后不良的预测价值。结果疾病组入院后第1 d外周血WBC、PMA水平均高于对照组,外周血PLT低于对照组,差异均有统计学意义(P<0.05)。ACI患者预后不良率为42.57%,预后不良组与预后良好组入院后第1d、3d、7d的外周血WBC、PMA水平依次降低,外周血PLT依次升高,差异均有统计学意义(P<0.05),且预后不良组入院后第3d、7d的外周血WBC、PMA均高于预后良好组,外周血PLT低于预后良好组,差异均有统计学意义(P<0.05)。梗死面积较大、入院时高水平美国国立卫生研究院卒中量表(NIHSS)评分、入院后第1 d C反应蛋白(CRP)及入院后第3d、7d外周血WBC、PMA水平较高、PLT水平较低均为ACI患者预后不良的危险因素,差异均有统计学意义(P<0.05)。ROC曲线结果显示,入院后第3d、7d外周血WBC、PLT、PMA联合预测ACI患者预后不良的曲线下面积(AUC)分别为0.941、0.921,均高于单独预测,差异均有统计学意义(P<0.05);入院后第3 d联合预测ACI患者预后不良的AUC高于入院后第7d联合预测。结论较大梗死面积、入院时高NIHSS评分、入院后第1 d高水平CRP以及入院后第3 d、第7 d高水平WBC、PMA和低水平PLT均是预后不良的危险因素。其中,外周�Objective To measure the early changes in peripheral blood white blood cell count(WBC),platelet count(PLT),and platelet-monocyte aggregates(PMA)in patients with acute cerebral infarction(ACI)and analyze their clinical significance.Methods A total of 148 ACI patients admitted to Zhengzhou Jinshui District General Hospital from September 2020 to March 2023 were selected as the disease group.An equal number of healthy volunteers who received physical check-ups during the same period were selected as the control group.The levels of peripheral blood WBC,PLT,and PMA were compared between the two groups.Based on the prognosis of the disease group,patients were divided into a good prognosis group and a poor prognosis group.The levels of peripheral blood WBC,PLT,and PMA,as well as general information,were compared at 1 day,3 days,and 7 days post-admission.Multivariate logistic regression analysis was used to identify factors leading to poor prognosis in ACI patients,and receiver operating characteristic(ROC)curves were plotted to analyze the predictive value of peripheral blood WBC,PLT,and PMA levels for poor prognosis in ACI patients.Results On the first day after admission,the levels of peripheral blood WBC and PMA in the disease group were higher than those in the control group,while the peripheral blood PLT levels were lower in the disease group,with statistically significant differences(P<0.05).The rate of poor prognosis in ACI patients was 42.57%.WBC and PMA levels decreased over time in both groups,while PLT levels increased,with statistically significant differences(P<0.05).Moreover,on days 3 and 7 post-admission,the WBC and PMA levels were higher in the poor prognosis group compared to the good prognosis group,while PLT levels were lower in the poor prognosis group,with significant differences(P<0.05).Larger infarct size,higher NIH Stroke Scale(NIHSS)scores at admission,elevated C-reactive protein(CRP)on day 1 post-admission,and higher WBC and PMA levels,along with lower PLT levels on days 3 and 7 post-admission,

关 键 词：急性脑梗死 白细胞计数 血小板计数 血小板-单核细胞聚集物 

分 类 号：R743.3[医药卫生—神经病学与精神病学]