摘要
目的探讨利用血小板参数和中性粒细胞与淋巴细胞比值(NLR)预测早期急性脑梗死严重程度。方法回顾性分析2017年7月~2019年1月空军特色医学中心急诊科就诊的急性脑梗死患者135例,根据改良的Rankin量表评分分为较轻组72例和较重组63例。比较2组一般临床资料,采用多因素logistic回归分析急性脑梗死较重的相关因素,利用ROC曲线评价血小板平均容积和NLR对急性脑梗死的预测价值。结果较重组血小板平均容积、中性粒细胞数和NLR明显高于较轻组,血小板计数明显低于较轻组(P<0.01)。多因素logistic回归分析显示,年龄、血小板计数和NLR是急性脑梗死严重程度的预测因素(P<0.05,P<0.01)。ROC曲线分析显示,血小板平均容积预测急性脑梗死较重的曲线下面积为0.656(95%CI:0.563~0.749),最佳诊断截点为9.600 fl,敏感性为74.6%,特异性为54.2%;NLR预测急性脑梗死较重的曲线下面积为0.701(95%CI:0.613~0.789),最佳诊断截点为2.476,敏感性为84.1%,特异性为51.4%。结论血小板平均容积和NLR对判断早期急性脑梗死严重程度具有一定预测价值。
Objective To study the application of platelet parameters and neutrophil/lymphocyte ratio(NLR)in predicting the severity of early acute cerebral infarcttion(ACI).Methods One hundred and thirty-five ACI patients were divided into mild ACI group(n=72)and severe ACI group(n=63)according to their mRS score.Their general clinical data were compared.The ACI-related factors were analyzed by multivariate logistic regression analysis.The value of mean platelet volume and NLR in predicting ACI was assessed by ROC curve analysis.Results The mean platelet volume was significantly larger,the neutrophil count was significantly greater and the NLR was significantly higher while the platelet count was significantly lower in severe ACI group than in mild ACI group(P<0.01).Multivariate logistic regression analysis showed that age,platelet count and NLR were the predictors for the severity of ACI(P<0.05,P<0.01).ROC curve analysis showed that the AUC for the mean platelet volume in predicting ACI was 0.656(95%CI:0.563-0.749)with a highest diagnostic cut-off point of 9.600 fl,a sensitivity of 74.6%and a specificity of 54.2%,and the AUC for the NLR in predicting ACI was 0.701(95%CI:0.613-0.789)with a highest diagnostic cut-off point of 2.476,a sensitivity of 84.1%,and a specificity of 51.4%.Conclusion Mean platelet volume and NLR play a certain role in predicting the severity of early ACI.
作者
靳磊
李敏
高坡
江海龙
张永生
陆孟妍
毕芳芳
王琦
Jin Lei;Li Min;Gao Po;Jiang Hailong;Zhang Yongsheng;Lu Mengyan;Bi Fangfang;Wang Qi(Anhui Medical University Air Force Clinical School,Department of Emergency,Air Force Medical Center,Beijing 100142,China)
出处
《中华老年心脑血管病杂志》
CAS
北大核心
2020年第6期605-608,共4页
Chinese Journal of Geriatric Heart,Brain and Vessel Diseases
基金
全军后勤科研重大项目(AKJ15J001)。
