静脉溶栓治疗后急性缺血性脑卒中患者白细胞计数和C反应蛋白的预后价值
Prognostic Value of White Blood Cell Counts and C-reactive Protein in Acute Ischemic Stroke Patients After Intravenous Thrombolysis.
作者信息
Qu Xinyuan, Shi Jijun, Cao Yongjun, Zhang Mingzhi, Xu Jiaping
机构信息
Department of Epidemiology, School of Public Health, Medical College of Soochow University, Suzhou, China.
Department of Neurology, The Second Affiliated Hospital of Soochow University, Suzhou, China.
出版信息
Curr Neurovasc Res. 2018;15(1):10-17. doi: 10.2174/1567202615666180326101524.
BACKGROUND
The prognostic value of White Blood Cell (WBC) counts and C-reactive Protein (CRP) in clinical outcomes of Acute Ischemic Stroke (AIS) patients after Intravenous Thrombolysis (IVT) remains unknown. We investigated the association of WBC counts and CRP with 3-month functional outcomes and all-cause mortality in AIS patients.
METHODS
447 AIS patients treated with IVT between May 2010 and May 2017 were enrolled. WBC counts and CRP were measured within 24 hours after IVT. The main outcomes included poor functional outcomes (modified Rankin score ≥3) at 3 months and 3-month all-cause mortality.
RESULTS
High WBC counts were associated with poor functional outcomes (adjusted OR (odds ratio) 4.48; 95% CI (confidence interval) 2.00-10.03; P-trend<0.001) and with all-cause mortality (adjusted HR (hazard ratio) 2.19; 95% CI 1.07-4.49; P-trend=0.018). In addition, high CRP levels were associated with poor functional outcomes (adjusted OR 4.95; 95% CI 1.39-17.65; Ptrend= 0.002). However, no significant association between high CRP levels and all-cause mortality was observed (adjusted HR 2.61; 95% CI 0.80-8.47; P-trend=0.138).
CONCLUSION
Our analysis indicated that elevated WBC counts and CRP levels after IVT can independently predict poor outcome among AIS patients.
背景
急性缺血性卒中（AIS）患者静脉溶栓（IVT）后白细胞（WBC）计数和C反应蛋白（CRP）对临床结局的预后价值仍不清楚。我们研究了AIS患者WBC计数和CRP与3个月功能结局及全因死亡率之间的关联。
方法
纳入2010年5月至2017年5月期间接受IVT治疗的447例AIS患者。在IVT后24小时内测量WBC计数和CRP。主要结局包括3个月时功能结局不良（改良Rankin量表评分≥3）和3个月全因死亡率。
结果
高WBC计数与功能结局不良（校正比值比（OR）4.48；95%置信区间（CI）2.00 - 10.03；P趋势<0.001）及全因死亡率相关（校正风险比（HR）2.19；95% CI 1.07 - 4.49；P趋势 = 0.018）。此外，高CRP水平与功能结局不良相关（校正OR 4.95；95% CI 1.39 - 17.65；P趋势 = 0.002）。然而，未观察到高CRP水平与全因死亡率之间存在显著关联（校正HR 2.61；95% CI 0.80 - 8.47；P趋势 = 0.138）。
结论
我们的分析表明，IVT后WBC计数和CRP水平升高可独立预测AIS患者预后不良。
Zotero 插件