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血小板与淋巴细胞比值与急性缺血性脑卒中相关性肺炎的关系。

Association of Platelet-to-Lymphocyte Ratio with Stroke-Associated Pneumonia in Acute Ischemic Stroke.

机构信息

Department of Neurology, Beijing Shijitan Hospital, Capital Medical University, Beijing 100038, China.

出版信息

J Healthc Eng. 2022 Mar 18;2022:1033332. doi: 10.1155/2022/1033332. eCollection 2022.

Abstract

A common consequence of acute ischemic stroke (AIS), stroke-associated pneumonia (SAP), might result in a poor prognosis after stroke. Based on the critical position of inflammation in SAP, this study aimed to explore the correlation between platelet-to-lymphocyte ratio (PLR) and the occurrence of SAP. We included 295 patients with acute ischemic stroke, 40 with SAP, and 255 without SAP. The area under the receiver operating characteristic curve was used to determine the diagnostic value of SAP risk factors using binary logistic regression analysis. The comparison between the two groups showed that age, the baseline National Institutes of Health Stroke Scale (NIHSS) score, and the proportion of dysphagia, atrial fibrillation, and total anterior circulation infarct were higher, and the proportion of lacunar circulation infarct was lower in the SAP group ( < 0.001). In terms of laboratory data, the SAP group had considerably greater neutrophil counts and PLR, while the non-SAP group ( < 0.001) had significantly lower lymphocyte counts and triglycerides. Binary logistic regression analysis revealed that older age (aOR = 1.062, 95% CI: 1.023-1.102,  = 0.002), atrial fibrillation (aOR = 3.585, 95% CI: 1.605-8.007,  = 0.019), and PLR (aOR = 1.003, 95% CI: 1.001-1.006,  = 0.020) were independent risk factors associated with SAP after adjusting for potential confounders. The sensitivity and specificity of PLR with a cutoff value of 152.22 (AUC: 0.663, 95% CI: 0.606-0.717,  = 0.0006) were 57.5% and 70.6%, respectively. This study showed that high PLR is an associated factor for SAP in AIS patients. Increased systemic inflammation is linked to SAP in ischemic stroke. Inflammatory biomarkers that are easily accessible may aid in the diagnosis of high-risk SAP patients.

摘要

急性缺血性脑卒中(AIS)的常见后果是卒中相关性肺炎(SAP),这可能导致卒中后预后不良。基于炎症在 SAP 中的关键作用,本研究旨在探讨血小板与淋巴细胞比值(PLR)与 SAP 发生之间的相关性。我们纳入了 295 例急性缺血性脑卒中患者,其中 40 例患有 SAP,255 例无 SAP。采用二元逻辑回归分析,通过受试者工作特征曲线下面积确定 SAP 危险因素的诊断价值。两组间比较显示,SAP 组年龄、基线国立卫生研究院卒中量表(NIHSS)评分、吞咽困难、心房颤动和全前循环梗死比例较高,腔隙性梗死比例较低(均<0.001)。实验室数据方面,SAP 组中性粒细胞计数和 PLR 显著较高,而非 SAP 组淋巴细胞计数和甘油三酯显著较低(均<0.001)。二元逻辑回归分析显示,年龄较大(OR=1.062,95%CI:1.023-1.102, =0.002)、心房颤动(OR=3.585,95%CI:1.605-8.007, =0.019)和 PLR(OR=1.003,95%CI:1.001-1.006, =0.020)是经潜在混杂因素校正后与 SAP 相关的独立危险因素。PLR 截断值为 152.22 时的灵敏度和特异性分别为 57.5%和 70.6%(AUC:0.663,95%CI:0.606-0.717, =0.0006)。本研究表明,高 PLR 是 AIS 患者 SAP 的相关因素。缺血性脑卒中患者的全身炎症反应增加与 SAP 相关。易于获得的炎症标志物可能有助于诊断高危 SAP 患者。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/36ed/8956427/72245370eddd/JHE2022-1033332.001.jpg

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