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血小板与白细胞比值与急性缺血性脑卒中患者机械取栓结局的关系。

The relationship between the platelet to leukocyte ratio and mechanical thrombectomy outcomes in acute ischemic stroke patients.

机构信息

Department of Neurology, The Fourth Affiliated Hospital of Anhui Medical University , Hefei, Anhui, China.

Department of Neurology, Jinling Hospital, Medical School of Nanjing University , Nanjing, Jiangsu, China.

出版信息

Neurol Res. 2020 Oct;42(10):890-896. doi: 10.1080/01616412.2020.1790868. Epub 2020 Jul 9.

Abstract

BACKGROUND AND PURPOSE

The predictive effect of blood cell ratio on ischemic event has been widely confirmed. Whether PWR and PNR can assess the risk of endovascular treatment (EVT) is largely unclear. This study aimed to investigate the prognostic value of PNR and PWR in acute ischemic stroke patients treated with EVT.

METHODS

Poor functional outcome was defined as Modified Rankin Scale (mRS) of 3-6 at 3 months, Symptomatic intracranial hemorrhage (sICH) was diagnosed based on CT scan and classified according to the criterial of Heidelberg Bleeding Classification. Binary logistical regression was used to analyze the relationship of PWR, PNR with functional outcome and symptomatic intracranial hemorrhage (sICH).

RESULTS

Patients with good prognosis had higher PNR and PWR value (29 vs. 24, P=0.002) (22 vs. 19, P=0.009), a lower rate of sICH (2.9% vs. 24.9%, P<0.001). In model 1, the lower PNR significantly associated with poor functional outcome (OR, 0.48; 95% CI 0.26-0.88; P=0.018), and sICH (OR, 0.42; 95% CI 0.19-0.91; P=0.028). The lower PWR only significantly associated with poor prognosis (OR, 0.97; 95% CI 0.94-1.00; P=0.038), and had a trend relation with sICH (OR, 0.98; 95% CI 0.94-1.02; P=0.328). In model 2 lower PNR still significantly associated with poor functional outcome (OR, 0.53; 95% CI 0.29-0.99; P=0.047), but showed a trend for predicting sICH (OR, 0.56; 95% CI 0.25-1.25; P=0.158).

CONCLUSION

Platelet to leukocyte ratio may be use to assess the risk of functional outcome and sICH in patients with acute anterior circulation occlusion stroke undergoing endovascular treatment in real world China.

摘要

背景与目的

血细胞比与缺血性事件的预测效果已被广泛证实。血小板与淋巴细胞比值(PLR)和中性粒细胞与淋巴细胞比值(NLR)能否评估血管内治疗(EVT)的风险尚不清楚。本研究旨在探讨 PLR 和 NLR 对接受 EVT 的急性缺血性脑卒中患者的预后价值。

方法

采用改良 Rankin 量表(mRS)评分,3 个月时 mRS 评分 3-6 分为预后不良,根据 CT 扫描诊断症状性颅内出血(sICH),并根据海德堡出血分类标准进行分类。采用二元逻辑回归分析 PWR 和 PNR 与功能结局和症状性颅内出血(sICH)的关系。

结果

预后良好的患者 PNR 和 PWR 值较高(29 比 24,P=0.002)(22 比 19,P=0.009),sICH 发生率较低(2.9%比 24.9%,P<0.001)。在模型 1 中,较低的 PNR 与不良功能结局显著相关(OR,0.48;95%CI,0.26-0.88;P=0.018),与 sICH 显著相关(OR,0.42;95%CI,0.19-0.91;P=0.028)。较低的 PWR 仅与不良预后显著相关(OR,0.97;95%CI,0.94-1.00;P=0.038),与 sICH 呈趋势相关(OR,0.98;95%CI,0.94-1.02;P=0.328)。在模型 2 中,较低的 PNR 仍与不良功能结局显著相关(OR,0.53;95%CI,0.29-0.99;P=0.047),但预测 sICH 的趋势较弱(OR,0.56;95%CI,0.25-1.25;P=0.158)。

结论

在真实世界的中国,血小板与白细胞比值(PLR)可能用于评估急性前循环闭塞性脑卒中患者接受血管内治疗后功能结局和 sICH 的风险。

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