Amalia Lisda, Dalimonthe Nadjwa Zamalek
Department of Neurology, Faculty of Medicine Universitas Padjadjaran, RSUP Dr. Hasan Sadikin Bandung, Indonesia.
Department of Clinical Pathology, Faculty of Medicine Universitas Padjadjaran, RSUP Dr. Hasan Sadikin Bandung, Indonesia.
Heliyon. 2020 Oct 7;6(10):e05033. doi: 10.1016/j.heliyon.2020.e05033. eCollection 2020 Oct.
Ischemic stroke can occur due to disruption of blood and oxygen supply to brain tissue. White blood cells and platelets play an important role in the pathogenesis of ischemic stroke. Several studies have concluded that the lower the platelet count and the higher the number of white blood cells in ischemic stroke patients will result in a more severe stroke and had worsen prognosis. Platelet and white blood cells counts can be converted into Platelet-to-White Blood Cell Ratio (PWR) which is a comparison between the number of platelets and white blood cells, so the higher PWR will provide better clinical outcomes. Here, we examined correlation between PWR and clinical outcome in acute ischemic stroke using NIHSS tools.
This research method was a retrospective analytic from 503 medical records of ischemic stroke patients from January 2015 to December 2017. Ischemic stroke divided into 2 groups: cardioembolic stroke and atherothrombotic stroke based on medical records. We calculated PWR and National Institute of Health Stroke Scale (NIHSS) for assessing clinical outcome. Statistical significance calculated with Spearman rank test, ANOVA, and multiple logistic regression.
A total of 391 research subjects consisting of 213 females (54.5%) and 178 males (45.5%). The mean age of 57.14 years, and 82% subjects had hypertension as risk factor. Mean PWR of atherothrombotic stroke subjects were higher than cardioembolic stroke (33.02 vs 26.73) but had lower mean of NIHSS (5.81 vs 10.31) and had strong negative significant correlation between PWR and NIHSS (r = -0.9603; p < 0.001). From logistic regression, we found that PWR and platelet was statistically significance correlate with NIHSS (p < 0.05). The coefficient if PWR is the highest (absolute value) among other independent variables.It shows that PWR has positive effect on clinical outcome using NIHSS tools in acute ischemic stroke patients.
Cardioembolic stroke had higher PWR compared with atherothrombotic stroke. PWR had a strong correlation with NIHSS. The higher PWR will provide higher NIHSS and PWR has positive effect on clinical outcome using NIHSS tools in acute ischemic stroke patients.
缺血性中风可能由于脑组织血液和氧气供应中断而发生。白细胞和血小板在缺血性中风的发病机制中起重要作用。多项研究得出结论，缺血性中风患者的血小板计数越低，白细胞数量越高，中风就会越严重，预后也会越差。血小板和白细胞计数可以转换为血小板与白细胞比值（PWR），即血小板数量与白细胞数量的比较，因此PWR越高，临床结果越好。在此，我们使用美国国立卫生研究院卒中量表（NIHSS）工具研究急性缺血性中风中PWR与临床结果之间的相关性。
本研究方法为对2015年1月至2017年12月期间503例缺血性中风患者的病历进行回顾性分析。根据病历，缺血性中风分为两组：心源性栓塞性中风和动脉粥样硬化血栓形成性中风。我们计算了PWR和美国国立卫生研究院卒中量表（NIHSS）以评估临床结果。采用Spearman秩检验、方差分析和多元逻辑回归计算统计学意义。
共有391名研究对象，其中女性213名（54.5%），男性178名（45.5%）。平均年龄为57.14岁，82%的研究对象有高血压作为危险因素。动脉粥样硬化血栓形成性中风患者的平均PWR高于心源性栓塞性中风患者（33.02对26.73），但NIHSS平均值较低（5.81对10.31），且PWR与NIHSS之间存在强烈的负相关（r = -0.9603；p < 0.001）。从逻辑回归分析中，我们发现PWR和血小板与NIHSS在统计学上具有显著相关性（p < 0.05）。在其他自变量中，PWR的系数最高（绝对值）。这表明在急性缺血性中风患者中，使用NIHSS工具时PWR对临床结果有积极影响。
与动脉粥样硬化血栓形成性中风相比，心源性栓塞性中风的PWR更高。PWR与NIHSS有很强的相关性。PWR越高，NIHSS得分越高，并且在急性缺血性中风患者中，使用NIHSS工具时PWR对临床结果有积极影响。
