血浆中性粒细胞与淋巴细胞比值预测急性缺血性脑卒中机械取栓患者半年预后的价值

Value of plasma neutrophil to lymphocyte ratio in predicting prognosis after half a year in acute ischemic stroke patients with mechanical thrombectomy

  • 摘要:
      目的  探讨血浆中性粒细胞与淋巴细胞比值(NLR)预测急性缺血性脑卒中(AIS)机械取栓患者半年预后的价值。
      方法  将105例AIS机械取栓患者根据半年后改良Rankin量表(mRS)评分结果分为预后良好组48例和预后不良组57例,比较2组患者的临床资料。将有统计学差异的相关指标采用二元Logistic回归分析,采用受试者工作特征(ROC)曲线评估预测价值。
      结果  预后良好组与预后不良组手术时间、中性粒细胞百分比、淋巴细胞百分比及NLR比较,差异有统计学意义(P < 0.05)。前循环梗死组与后循环梗死组手术时间、入院美国国立卫生研究院卒中量表(NIHSS)比较,差异有统计学意义(P < 0.05)。颈内动脉闭塞组与大脑中动脉闭塞组相关临床资料比较,差异无统计学意义(P>0.05)。二元Logistic回归分析结果显示,手术时间、NLR是预测急性脑梗死机械取栓患者半年预后的独立危险因子。NLR判断急性脑梗死取栓半年预后的ROC曲线下面积(AUC)为0.759, 当最佳临界值为4.685时,其约登指数为0.565, 敏感度为74.50%, 特异度为82.00%, 95%CI为0.662~0.855。手术时间判断急性脑梗死取栓半年预后的AUC为0.623, 当最佳临界值为81.500 min时,其约登指数为0.245, 敏感度为74.50%, 特异度为50.00%, 95%CI为0.516~0.731。
      结论  血浆NLR的升高对AIS机械取栓半年不良预后有较好的预测价值。

     

    Abstract:
      Objective  To explore the value of plasma neutrophil to lymphocyte ratio (NLR) in predicting prognosis after half a year in acute ischemic stroke (AIS) patients with mechanical thrombectomy.
      Methods  Totally 105 AIS patients with mechanical thrombectomy were divided into good prognosis group (n=48) and poor prognosis group (n=57) according to the score of modified Rankin Scale (mRS) after half a year, and the clinical materials were compared between the two groups. Binary Logistic regression analysis was used to analyze the related indicators with statistical differences, and the receiver operating characteristic (ROC) curve was used to evaluate the predictive value.
      Results  There were significant differences in operation time, neutrophil percentage, lymphocyte percentage and NLR between the two groups (P < 0.05). There were significant differences in operation time and National Institute of Health Stroke Scale (NIHSS) between anterior circulation infarction group and posterior circulation infarction group (P < 0.05). There was no significant difference in clinical materials between internal carotid artery occlusion group and middle cerebral artery occlusion group (P>0.05). Binary Logistic regression analysis showed that operation time and NLR were independent risk factors for predicting prognosis after half a year in acute cerebral infarction patients with mechanical thrombectomy. The area under the ROC curve (AUC) of NLR in predicting prognosis after half a year in acute cerebral infarction patients with mechanical thrombectomy was 0.759. When the optimal critical value was 4.685, the Youden index was 0.565, the sensitivity was 74.50%, the specificity was 82.00%, and the 95% CI was from 0.662 to 0.855. The AUC of operation time in predicting prognosis after half a year in acute cerebral infarction patients with mechanical thrombectomy was 0.623. When the optimal cut-off value was 81.500 min, the Youden index was 0.245, the sensitivity was 74.50%, the specificity was 50.00%, and the 95% CI was from 0.516 to 0.731.
      Conclusion  The increase of plasma NLR has a good predictive value for the poor prognosis after half a year in AIS patients with mechanical thrombectomy.

     

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