【摘要】 目的探讨单核细胞与HDL-C比值(monocyte-to-HDL cholesterol ratio,MHR)与急性缺血性卒中(acute ischemic stroke,AIS)静脉溶栓短期预后的关系。方法回顾性纳入2015年1月1日-2017年12月1日在郑州大学第一附属医院神经内科急诊接受静脉溶栓治疗的AIS患者。患者预后通过90 dmRS来评估,良好预后定义为mRS评分≤2分。采用多因素Logistic回归分析MHR及其他基线资料与90 d预后的关系,应用ROC曲线评价MHR对预后的预测价值。结果共纳入281例患者,平均年龄59.54±12.49岁,男性183例(65.1%),良好预后223例(79.4%)。多因素Logistic回归分析显示,高龄(OR 1.03,95%CI 1.01～1.06,P=0.013)、溶栓前NIHSS评分高(OR1.31,95%CI 1.17～1.44,P<0.001)和高MHR(OR 2.39,95%CI 1.10～5.25,P=0.028)是AIS静脉溶栓患者90 d不良预后的独立影响因素。亚组分析显示,高MHR(OR 5.15,95%CI 1.28～20.77,P=0.021)是大动脉粥样硬化型AIS静脉溶栓90 d不良预后的独立影响因素。ROC曲线分析显示,MHR预测预后不良的最佳界值为0.48,其敏感度和特异度分别为79.41%和58.33%。结论 MHR是AIS尤其大动脉粥样硬化型静脉溶栓短期预后的独立影响因素。更多还原

【Abstract】 Objective To investigate the relationship between monocyte-to-HDL cholesterol ratio(MHR) and short-term prognosis in acute ischemic stroke(AIS) patients treated with intravenous thrombolysis.Methods A retrospective analysis of consecutive AIS patients treated with intravenous thrombolysis in Department of Neurology of the First Affiliated Hospital of Zhengzhou University from January 2015 to December 2017 was undertaken. Functional outcome at 90 days was evaluated by the mRS. Good outcome was defined as a mRS score of 0-2. Multivariate logistic regression analysis was conducted to evaluate the relationship between MHR and 90-day outcome. The ROC curve analysis was performed to evaluate the predictive value.Results A total of 281 patients were included, with an average age of 59.54±12.49 years and 183 males(65.1%). 223 cases(79.4%) had good prognosis. Multivariate analysis showed that higher age(OR 1.03, 95%CI 1.01-1.06, P=0.013), baseline NIHSS score(OR 1.31, 95%CI 1.17-1.44, P<0.001) and MHR(OR 2.39, 95%CI 1.10-5.25, P=0.028) were independent predictors for 90-day poor prognosis. Subgroup analysis showed that high MHR(OR 5.15, 95%CI 1.28-20.77, P=0.021) was an independent predictor for 90-day poor prognosis in patients with large atherosclerotic stroke. ROC curve analysis showed that the optimal cut-off point of MHR was 0.48, and the sensitivity and specificity of predicting short-term poor prognosis were 79.41% and 58.33%.Conclusions MHR was an independent predictor for short-term prognosis after venous thrombolysis in AIS patients, especially in patients with large atherosclerotic stroke.更多还原