血浆NLR、PLR及其联合指标对脑梗死溶栓患者预后的预测价值

doi:0.3969/j.issn.1004-583X.2020.03.007

临床荟萃

血浆NLR、PLR及其联合指标对脑梗死溶栓患者预后的预测价值

1.承德医学院，河北承德 067000；2.承德市中心医院神经内科，河北承德 067000

出版日期:2020-03-20 发布日期:2020-03-27
通讯作者: 朱海暴, Email：zhuhaibao1977@163.com
基金资助:
承德市科学技术研究与发展计划项目----轻型缺血性卒中或TIA静脉溶栓及替罗非班治疗的研究 (201903A009)

Predictive value of plasma NLR, PLR and their combinedindex in prognosis of thrombolysis in patients with cerebral infarction

1.Chengde Medical College, Chengde 067000, China; 2.Department of Neurology, Chengde Central Hospital, Chengde 067000, China

Online:2020-03-20 Published:2020-03-27
Contact: Correspondiong author: Zhu Haibao, Email: zhuhaibao1977@163.com

摘要/Abstract

摘要： 目的探讨脑梗死静脉溶栓患者24小时内血浆中性粒细胞与淋巴细胞比值（NLR）、血小板与淋巴细胞比值（PLR）及其联合检测对患者预后的预测价值。方法连续纳入进行脑梗死静脉溶栓治疗的患者128例，据溶栓治疗90天后的改良Rankin量表（mRS）评分结果分为预后良好组（mRS 0～2分，75例）和预后不良组（mRS 3～6分，53例）。收集患者一般资料，检测溶栓后血常规、血尿酸、血同型半胱氨酸、血脂，计算NLR及PLR。用二元Logistic回归分析后进一步用受试者工作特征曲线（ROC）进行评价，得出其对脑梗死溶栓患者预后的预测价值。结果两组NLR、PLR比较差异均有统计学意义（P<0.01），用ROC曲线对NLR、PLR及其联合指标进一步分析发现，NLR判断脑梗死溶栓预后的ROC曲线下面积（AUC）为0.772，当最佳临界值为3.755时，敏感度为69.8%，特异度为74.7%。PLR判断脑梗死溶栓预后AUC=0.746，当最佳临界值为145.055时，敏感度为64.2%，特异度为78.7%。NLR与PLR联合检测脑梗死溶栓预后的AUC=0.781，临界值为1.337时，敏感度为69.8%，特异度为76.5%。结论 NLR、PLR及其联合指标作为新型炎症指标，其升高对脑梗死溶栓患者不良预后有较好的预测价值。

关键词: 脑梗死, 溶栓, 中性粒细胞与淋巴细胞比值, 血小板与淋巴细胞比值

Abstract: Objective To investigate the predictivevalue of plasma neutrophilto lymphocyte ratio (NLR), plateletto lymphocyte ratio (PLR) in the prognosis of intravenous thrombolysis in patients with cerebral infarction within 24 hours. Methods Totally 128 patients who received intravenous thrombolysis for cerebral infarction were continuously included.According to the modified Rankin scale (mRS) score after 90 days of thrombolytic therapy, all patients were separated into good prognosis group (mRS 02 points, 75 cases) and poor prognosis group (mRS 36 points, 53 cases). General information of patients were collectedin order to measure the blood routine, blood uric acid, homocysteine, blood lipidand calculate NLR and PLR after thrombolysis. Following the binary logistic regression analysis, the receiver operating characteristic curve (ROC) was used to further evaluate the predictive value for the prognosis of thrombolysis in patients with cerebral infarction. Results There were statistically significant difference in NLR and PLR between two groups (P<0.01). Further analysis of NLR, PLR, and their combined indicators by using ROC found that the area under the curve (AUC) for judging the prognosis of thrombolytic therapy in cerebral infarction was 0.772. When the optimal threshold was 3.755, the sensitivity was 69.8% and the specificity was 74.7%. And the AUC measured by the detection of PLR was 0.746. When the optimal threshold was 145.055, the sensitivity was 64.2% and the specificity was 78.7%. The AUC measured by the combined detection of NLR and PLR was 0.781. When the critical value was 1.337, the sensitivity was 69.8% and the specificity was 76.5%.Conclusion The NLR, PLR and their combined indicators are new indicators of inflammation, and their elevation has good predictive value for the poor prognosis of thrombolysis in patients with cerebral infarction.

Key words: cerebral infarction, thrombolysis, neutrophil to lymphocyte ratio, platelet to lymphocyte ratio

靳佳敏1, 马翠红2, 范昆鹏1，张俊莲1, 朱海暴2. 血浆NLR、PLR及其联合指标对脑梗死溶栓患者预后的预测价值[J]. 临床荟萃, doi: 0.3969/j.issn.1004-583X.2020.03.007.

Jin Jiamin1, Ma Cuihong2, Fan Kunpeng1, Zhang Junlian1, Zhu Haibao2. Predictive value of plasma NLR, PLR and their combinedindex in prognosis of thrombolysis in patients with cerebral infarction[J]. Clinical Focus, doi: 0.3969/j.issn.1004-583X.2020.03.007.

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链接本文: https://huicui.hebmu.edu.cn/CN/0.3969/j.issn.1004-583X.2020.03.007

https://huicui.hebmu.edu.cn/CN/Y2020/V35/I3/228

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血浆NLR、PLR及其联合指标对脑梗死溶栓患者预后的预测价值

Predictive value of plasma NLR, PLR and their combinedindex in prognosis of thrombolysis in patients with cerebral infarction

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