| 摘要: |
| 目的 研究中性粒细胞与淋巴细胞比值（NLR）对卒中预警综合征（SWS）患者预后的预测价值。方法 回顾性连续纳入2013年7月至2020年1月于海军军医大学（第二军医大学）第一附属医院住院治疗的SWS患者83例，根据改良Rankin量表（mRS）评分分为预后良好组（mRS评分≤2分，72例）和预后不良组（mRS评分＞2分，11例）。记录患者基本临床特点、实验室及影像学等资料，根据急诊血常规计算NLR。采用logistic回归模型分析SWS预后不良的影响因素，采用ROC曲线评价NLR对SWS患者预后的预测作用。结果 SWS患者平均年龄为（59.10±13.11）岁，65例患者明确新发梗死。预后不良组患者入院时美国国立卫生研究院卒中量表（NIHSS）评分、NLR均高于预后良好组，但血红蛋白水平低于预后良好组，差异有统计学意义（P均＜0.05）。两组间ABCD2评分及是否行静脉溶栓和有无新发梗死的患者比例差异无统计学意义（P均＞0.05）。多因素logistic回归分析显示，入院时NIHSS评分（OR＝1.46，95% CI 1.15～1.86，P＝0.002）和NLR（OR＝2.05，95% CI 1.07～3.92，P＝0.031）是SWS患者预后不良的独立危险因素。ROC曲线分析显示，当NLR诊断临界值为2.82时，AUC值为0.75，NLR预测SWS患者预后不良的灵敏度为72.7%，特异度为81.9%。结论 较高的入院时NIHSS评分和NLR与SWS患者预后不良独立相关，且NLR对SWS患者预后不良具有中度诊断价值。 |
| 关键词: 卒中预警综合征 急性缺血性脑卒中 预后 中性粒细胞与淋巴细胞比值 |
| DOI：10.16781/j.CN31-2187/R.20230334 |
| 投稿时间：2023-06-15修订日期：2023-10-10 |
| 基金项目:上海申康医院发展中心临床三年行动计划(SHDC2020CR1038B). |
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| Predictive value of neutrophil to lymphocyte ratio for prognosis of patients with stroke warning syndrome |
| WANG Nuo1,DENG Benqiang1,CHEN Lei1,WU Tao2*,BI Xiaoying1* |
(1. Department of Neurology, The First Affiliated Hospital of Naval Medical University (Second Military Medical University), Shanghai 200433, China;
2. Department of Neurology, Shanghai Fourth People's Hospital, Tongji University, Shanghai 200434, China
*Corresponding authors) |
| Abstract: |
| Objective To investigate the predictive value of neutrophil to lymphocyte ratio (NLR) for the prognosis of patients with stroke warning syndrome (SWS). Methods From Jul. 2013 to Jan. 2020, 83 SWS patients admitted to The First Affiliated Hospital of Naval Medical University (Second Military Medical University) were retrospectively enrolled. According to the modified Rankin scale (mRS) score, the patients were divided into good prognosis group (mRS score≤2, n＝72) and poor prognosis group (mRS score＞2, n＝11). The clinical characteristics, laboratory data and imaging data were recorded, and the NLR was calculated according to the results of emergency blood routine test. Logistic regression model was used to analyze the influencing factors of poor prognosis of SWS patients. The receiver operating characteristic (ROC) curve was used to evaluate the predictive effect of NLR for the prognosis of SWS patients. Results The average age of SWS patients was (59.10±13.11) years old, and 65 patients had new cerebral infarction. Admission National Institutes of Health stroke scale (NIHSS) score and NLR of the patients in the poor prognosis group were significantly higher than those in the good prognosis group, while the hemoglobin level was significantly lower than that in the good prognosis group (all P＜0.05). There were no significant differences in ABCD2 (age, blood pressure, clinical features, duration of symptoms and diabetes) score, intravenous thrombolysis, or new infarction between the 2 groups (all P＞0.05). Multivariate logistic regression analysis showed that admission NIHSS score (odds ratio ［OR］ 1.46, 95% confidence interval ［CI］ 1.15-1.86, P＝0.002) and NLR (OR 2.05, 95% CI 1.07-3.92, P＝0.031) were independent risk factors for poor prognosis of SWS patients. ROC curve analysis showed a cutoff value of 2.82 for NLR in predicting poor prognosis in SWS patients, with a value of area under curve of 0.75, a sensitivity of 72.7%, and a specificity of 81.9%. Conclusion Higher admission NIHSS score and NLR are independently correlated with poor prognosis of SWS patients, and NLR has moderate diagnostic value for poor prognosis of SWS patients. |
| Key words: stroke warning syndrome acute ischemic stroke prognosis neutrophil to lymphocyte ratio |
