【摘要】 目的 探讨急性轻型缺血性脑卒中患者中性粒细胞-淋巴细胞比值(Neutrophil-lymphocyte ratio, NLR)和血小板-淋巴细胞比值(Platelet-lymphocyte ratio, PLR)对卒中后3个月认知障碍的预测价值。方法 以2020年12月至2022年5月锦州市中心医院的首发缺血性脑卒中住院患者254例为研究对象，测定患者入院时NLR和PLR,在卒中后3个月采用蒙特利尔认知评价量表(Montreal cognitive assessment, MoCA)对其进行认知功能评分。根据评分结果分为卒中后认知障碍(post-stroke cognitive impairment, PSCI)组101例和卒中后无认知障碍(no cognitive impairment, NCI)组153例。采用Logistic回归分析筛选PSCI危险因素。通过绘制受试者工作特征(receiver operating characteristic curve, ROC)曲线分析NLR和PLR对PSCI的预测价值。结果 PSCI组NLR中位数为3.74(3.41,5.15),NCI组NLR中位数为3.15(2.80,3.82),两组差异有统计学意义(P<0.05);PSCI组PLR中位数为131.78(122.63,149.56),NCI组PLR中位数为114.70(91.44,134.52),两组差异有统计学意义(P<0.05)。Logistic回归显示NLR(OR值：1.437,95%CI:1.045～1.978,P=0.026)和PLR(OR值：1.011, 95%CI:1.001～1.021,P=0.030)均为PSCI的危险因素。NLR和PLR预测卒中后3个月认知障碍，NLR的ROC曲线下面积(Area under the curve, AUC)为0.695[95%CI(0.627,0.763)],最佳截断值为4.19,敏感度为43.6%,特异度为82.4%,PLR的AUC为0.677[95%CI(0.610,0.745)],最佳截断值为119.58,敏感度为79.2%,特异度为59.5%。结论 缺血性卒中急性期的NLR、PLR与卒中后3个月认知障碍独立相关。NLR、PLR对卒中后3个月认知障碍有一定预测价值。更多还原

【Abstract】 Objective To investigate the value of neutrophil-lymphocyte ratio(NLR) and platelet-lymphocyte ratio(PLR) in predicting cognitive impairment at 3 months of acute mild ischemic stroke. Methods A total of 254 hospitalized patients with an initial ischemic stroke from December 2020 to May 2022 in Central Hospital of Jinzhou were selected as the study objects.NLR and PLR were measured at admission. Cognitive function was evaluated at 3 months of stroke by the Montreal Cognitive Assessment(MoCA). According to the MoCA score, patients were classified into post-stroke cognitive impairment group(PSCI group, n=101)and non-cognitive impairment group(NCI group, n=153). Logistic regression was used to screen the risk factors of PSCI. The predictive values of NLR and PLR in PSCI were analyzed by drawing the receiver operating characteristic(ROC) curves.Results There were significant differences in the median NLR(3.74[3.41, 5.15] vs 3.15[2.80, 3.82]) and PLR(131.78 [122.63, 149.56] vs 114.70[91.44, 134.52]) between PSCI group and NCI group(both P<0.05). Logistic regression showed that both NLR(OR=1.437, 95%CI: 1.045-1.978, P=0.026) and PLR(OR=1.011, 95%CI: 1.001-1.021, P=0.030) were risk factors for PSCI. The area under the curve(AUC) of NLR in predicting cognitive impairment at 3 months of stroke was 0.695(95%CI: 0.627, 0.763), with the cut-off value, sensitivity and specificity of 4.19, 43.6% and 82.4%, respectively. The AUC of PLR in predicting cognitive impairment at 3 months of stroke was 0.677(95%CI: 0.610, 0.745), with the cut-off value, sensitivity and specificity of 119.58, 79.2% and 59.5%, respectively.Conclusion NLR and PLR in the acute phase of ischemic stroke are independently correlated with cognitive impairment at 3 months of stroke, which can predict cognitive impairment at 3 months of stroke.更多还原