摘要
目的探讨中性粒细胞/淋巴细胞比值(NLR)变化对急性缺血性脑卒中(AIS)患者阿替普酶静脉溶栓后预后的影响。方法选取2019年1月至2021年2月渑池县人民医院收治的117例AIS患者,均行阿替普酶静脉溶栓。静脉溶栓后3个月根据其改良Rankin量表(mRS)评分进行预后评估,分为预后不良组(45例,mRS评分3~6分)、预后良好组(72例,mRS评分0~2分)。检测NLR水平,分析NLR变化对AIS患者静脉溶栓后mRS评分的影响。结果溶栓后1、7 d,预后不良组中性粒细胞、NLR及国立卫生研究院卒中量表(NIHSS)评分均高于预后良好组,淋巴细胞低于预后良好组(P<0.05)。阿替普酶静脉溶栓后1、7 d中性粒细胞、NLR、NIHSS评分与mRS评分呈正相关,阿替普酶静脉溶栓后1、7 d淋巴细胞与mRS评分呈负相关(P<0.05)。阿替普酶静脉溶栓前和溶栓后1、7 d的NLR对应的曲线下面积(AUC)分别为0.773、0.792、0.892。阿替普酶静脉溶栓后7 d NLR预测AIS患者预后不良的敏感度、特异度较溶栓前、溶栓后1 d的对应值高(P<0.05)。结论NLR水平与AIS患者阿替普酶静脉溶栓后mRS评分呈正相关。临床监测NLR水平变化,对病情监测和治疗方案的制定具有指导意义,有利于改善AIS患者的预后。
Objective To explore the influence of neutrophil/lymphocyte ratio(NLR)on the prognosis of patients with acute ischemic stroke(AIS)after intravenous thrombolysis with alteplase.Methods From January 2019 to February 2021,117 AIS patients in People’s Hospital of Mianchi County were selected,and all of them were treated with intravenous thrombolysis with alteplase.Three months after intravenous thrombolysis,the prognosis was evaluated according to modify Rankin scale(mRS)score,and they were divided into poor prognosis group(45 cases with mRS score of 3-6)and good prognosis group(72 cases with mRS score of 0-2).The level of NLR was detected,and the influence of NLR changes on mRS scores of AIS patients after intravenous thrombolysis was analyzed.Results At 1 and 7 days after thrombolysis,the levels of neutrophils,NLR and the score of National Institute of Health stroke scale(NIHSS)in poor prognosis group were higher than those in good prognosis group,but the level of lymphocytes was lower than that in good prognosis group(P<0.05).The levels of neutrophils,NLR and NIHSS at 1 and 7 days after intravenous thrombolysis with alteplase were positively correlated with mRS score,while the lymphocytes at 1 and 7 days after intravenous thrombolysis with alteplase were negatively correlated with mRS score(P<0.05).The area under curve(AUC)of NLR before intravenous thrombolysis,1 and 7 days after thrombolysis were 0.773,0.792 and 0.892 respectively.The sensitivity and specificity of NLR in predicting the poor prognosis of AIS patients at 7 days after intravenous thrombolysis with alteplase were higher than those before and 1 day after thrombolysis(P<0.05).Conclusion NLR level is positively correlated with mRS score of AIS patients after intravenous thrombolysis with alteplase.Monitoring the changes of clinical NLR level is of guiding significance to the monitoring of disease condition and the formulation of treatment plan,and is conducive to improving the prognosis of AIS patients.
作者
何明伍
贺海涛
HE Mingwu;HE Haitao(Department of Neurology,People’s Hospital of Mianchi County,Sanmenxia 472400,China)
出处
《河南医学研究》
CAS
2022年第12期2219-2222,共4页
Henan Medical Research
