本文選題：急性腦梗死 + 淋巴細(xì)胞　； 參考：《中國腦血管病雜志》2017年02期

【摘要】：目的探討中性粒細(xì)胞與淋巴細(xì)胞比值(NLR)對急性腦梗死患者預(yù)后的預(yù)測價值。方法回顧性連續(xù)納入2014年1月至2015年12月鄭州大學(xué)第五附屬醫(yī)院神經(jīng)內(nèi)科住院的急性腦梗死患者307例,其中女80例,男227例。根據(jù)改良Rankin量表評分標(biāo)準(zhǔn),分為預(yù)后良好組(195例)和預(yù)后不良組(112例)。記錄入院時年齡、性別、既往病史、美國國立衛(wèi)生研究院卒中量表(NIHSS)評分等資料,根據(jù)入院中性粒細(xì)胞計數(shù)與淋巴細(xì)胞計數(shù)計算出NLR值。采用Logistics回歸分析急性腦梗死預(yù)后不良的影響因素,采用受試者工作特征(ROC)曲線評價入院時NLR水平對急性腦梗死患者預(yù)后不良的預(yù)測作用。結(jié)果 (1)與預(yù)后良好組比較,預(yù)后不良組患者年齡、復(fù)發(fā)性腦梗死發(fā)生率、入院時NIHSS評分、入院NLR水平均較高,組間差異均有統(tǒng)計學(xué)意義[(69±12)歲比(62±14)歲,25.0%(28/112)比14.4%(28/195),5.00(3.00,9.00)分比3.00(1.75,5.00)分,3.66(2.62,7.91)比2.47(1.94,3.40),均P0.05],其余基線資料和臨床特征的組間差異均無統(tǒng)計學(xué)意義(均P0.05)。(2)多因素Logistics回歸分析結(jié)果顯示,年齡、入院NIHSS評分及入院時NLR水平的升高,是預(yù)后不良的獨立危險因素(OR值分別為1.030,1.148,1.427,95%CI分別為1.007~1.053,1.059~1.246,1.247~1.634,均P0.05)。(3)入院時NLR水平對急性腦梗死患者預(yù)后不良的診斷界值為2.84,其敏感度為69.6%,特異度為64.6%。結(jié)論入院時NLR水平增高對評估急性腦梗死患者預(yù)后不良具有一定的參考價值。
[Abstract]:Objective to investigate the prognostic value of neutrophil / lymphocyte ratio (NLR) in patients with acute cerebral infarction. Methods 307 patients with acute cerebral infarction admitted to the Department of Neurology, Fifth affiliated Hospital of Zhengzhou University from January 2014 to December 2015, including 80 women and 227 men. According to the modified Rankin scale, the patients were divided into good prognosis group (195 cases) and poor prognosis group (112 cases). Age, sex, past medical history and NIHSS score were recorded at admission. The NLR values were calculated according to the neutrophil count and lymphocyte count. Logistics regression analysis was used to evaluate the prognostic factors of acute cerebral infarction (ACI) and the predictive effect of NLR level on the prognosis of patients with acute cerebral infarction (ACI) was evaluated by using the operating characteristics of the subjects. Results compared with the good prognosis group, the patients with poor prognosis had higher age, recurrent cerebral infarction rate, NIHSS score at admission and NLR level at admission. There were significant differences between the two groups [69 鹵12 years old vs 62 鹵14 years old: 28% 11: 12) vs 14.44% 28 / 195 5.003.00 / 9.00) scores compared with 3.00 1.755.00 scores (3.66 鹵2.627.91) vs 2.471.94nd3.40g (P0.05). There was no significant difference between the other baseline data and the clinical features (all P0.05.2.0. 2). The results of Logistics regression analysis showed that there were no significant differences between the other baseline data and the clinical features (all P0.05. 2), and the results of Logistics regression analysis showed that there was no significant difference between the two groups in terms of age, and clinical characteristics (P > 0.05), and the results of Logistics regression analysis showed that there were no significant differences between the two groups (P < 0.05). The NIHSS score and the increase of NLR level on admission were independent risk factors for poor prognosis. The OR values were 1.030 / 1.148 / 1.427795 / 95 CI = 1.007 / 1.053 / 1.0591.2461.247/ 1.634, respectively. The threshold value of NLR level for the poor prognosis of patients with acute cerebral infarction was 2.84, the sensitivity was 69.6and the specificity was 64.6. Conclusion the increase of NLR level at admission has some reference value in evaluating the poor prognosis of patients with acute cerebral infarction.
【作者單位】： 鄭州大學(xué)第五附屬醫(yī)院神經(jīng)內(nèi)科;
【基金】：國家自然科學(xué)基金資助項目(81571137) 河南省科技創(chuàng)新領(lǐng)軍人才(52110052)
【分類號】：R743.33

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