【摘要】 目的探讨中性粒细胞/淋巴细胞比值对急性缺血性脑卒中患者预后的影响。方法选取2016年1月至2018年3月该院收治的急性缺血性脑卒中患者100例为研究对象,均接受阿替普酶静脉溶栓治疗。检测患者溶栓前后中性粒细胞/淋巴细胞比值。根据溶栓后3个月的改良Rankin量表(mRS)评分将患者分为预后良好组(n=60,mRS评分为0～2分)和预后不良组(n=40,mRS评分为3～6分)。分析溶栓前后患者中性粒细胞/淋巴细胞比值与预后相关性,并分析缺血性脑卒中预后的影响因素。结果溶栓前预后不良组及预后良好组中性粒细胞/淋巴细胞比值差异无统计学意义(P>0.05);溶栓后,预后不良组及预后良好组中性粒细胞/淋巴细胞比值分别为4.53±1.23、3.11±1.04,差异有统计学意义(P<0.05)。预后不良组高血压史、高血脂史、脑卒中史患者所占比例,血糖、三酰甘油水平,治疗前美国国立卫生研究院卒中量表(NIHSS)评分,溶栓后中性粒细胞/淋巴细胞比值升高比例均高于预后良好组,差异有统计学意义(P<0.05)。多因素分析结果显示,治疗前NIHSS评分≥12分(P=0.002,OR:2.454,95%CI:1.620～9.294)、溶栓后中性粒细胞/淋巴细胞比值>2.1(P=0.031,OR:1.541,95%CI:1.138～7.124)、合并高血脂(P=0.022,OR:1.819,95%CI:1.254～6.974)、溶栓前血糖≥7.0mmol/L(P=0.035,OR:1.374,95%CI:1.123～4.887)是急性缺血性脑卒中溶栓后预后不良的独立影响因素(P<0.05)。结论溶栓后中性粒细胞/淋巴细胞比值与急性缺血性脑卒中预后相关,中性粒细胞/淋巴细胞比值升高者预后不良。更多还原

【Abstract】 Objective To investigate the effect of neutral-particle/lymphocyte ratio on the prognosis of patients with acute cerebral infarction,and to provide reliable prognostic indicators for patients with cerebral infarction.Methods A total of 100 patients with acute cerebral infarction admitted to our hospital from January2016 to March 2018 were treated with alteplase intravenous thrombolysis.The neutrophil/lymphocyte ratio in the blood before and after thrombolysis was measured.Patients were divided into a good prognosis group(n=60,mRS score 0-2)and a poor prognosis group(n=40,mRS 3-6 points)according to the modified Rankin scale(mRS)3 months after thrombolysis.The correlation between neutrophil/lymphocyte ratio and prognosis in blood before and after thrombolysis was analyzed,and the influencing factors of prognosis of cerebral infarction were analyzed.Results There was no significant difference in the ratio of neutrophil/lymphocyte between the poor prognosis group and the good prognosis group before thrombolysis(P>0.05).After thrombolysis,the neutrophil/lymphocyte ratio in the poor prognosis group and the good prognosis group were(4.53±1.23)and(3.11±1.04),the difference within the groups was statistically significant(P<0.05).The proportion of hypertension,hyperlipidemia,stroke history,levels of blood glucose,triglyceride,pre-treatment NIHSS score,and neutrophil/lymphocyte ratio after thrombolysis in the poor prognosis group were higher than those in the good prognosis group,the difference was statistically significant(P<0.05).Multivariate analysis showed that the pre-treatment NIHSS score higher than 12 scores(P=0.002,OR:2.454,95%CI:1.620-9.294),neutrophil/lymphocyte ratio after thrombolysis higher than 2.1(P=0.031,OR:1.541,95%CI:1.138-7.124),patients combined with hyperlipidemia(P=0.022,OR:1.819,95%CI:1.254-6.974),pre-thrombotic blood glucose higher than 7.0 mmol/L(P=0.035,OR:1.374,95%CI:1.123-4.887)were independent influence factors in acute cerebral infarction patients with poor prognosis(P<0.05).Conclusion The ratio of neutrophil/lymphocyte after thrombolysis is related to the prognosis of acute cerebral infarction.Patients with increase of neutrophil/lymphocyte ratio have a poor prognosis.更多还原