脑白质高信号与中性粒细胞与淋巴细胞比值联合预测急性缺血性脑卒中患者的短期预后。
Combination of White Matter Hyperintensity and Neutrophil-to-Lymphocyte Ratio Predicts Short-Term Prognosis of Acute Ischemic Stroke Patients.
作者信息
Zhang Qingyan, Ma Danyue, Du Hebin, Wang Tiantian, Li Wei
机构信息
Key Laboratory of Ultra-Weak Magnetic Field Measurement Technology, Ministry of Education, School of Instrumentation and Optoelectronic Engineering, Beihang University, Beijing, 100191, People's Republic of China.
Zhejiang Provincial Key Laboratory of Ultra-Weak Magnetic-Field Space and Applied Technology, Hangzhou Innovation Institute of Beihang University, Hangzhou, 310000, People's Republic of China.
出版信息
Int J Gen Med. 2024 Dec 14;17:6199-6206. doi: 10.2147/IJGM.S486511. eCollection 2024.
PURPOSE
To assess the value of combination of white matter hyperintensity (WMH) and neutrophil-to-lymphocyte ratio (NLR) in predicting short-term prognosis of acute ischemic stroke (AIS) patients.
PATIENTS AND METHODS
Three hundred and nine AIS patients were included in this prospective observational research. They were evaluated at 3-month after the onset of AIS using modified Rankin Scale (mRS) score. A mRS score of 0-2 was defined as a favourable outcome, while an mRS score of 3-6 was defined as an unfavourable outcome. Multivariate analysis was used to identify the independent associations of WMH and NLR with short-term prognosis of AIS patients, and receiver operating characteristic (ROC) curves were used to evaluate the predictive values of WMH, NLR and their combination for short-term prognosis of AIS patients, and test was used to compare the area under curve (AUC).
RESULTS
Among 309 AIS patients, 201 (65.0%) had a favorable 3-month outcome, while 108 (35.0%) had an unfavorable outcome. According to the results of multivariate analysis, WMH, NLR and on-admission NIHSS score were independently associated with unfavourable outcome of AIS after adjusting for diabetes mellitus, atrial fibrillation, TOAST subtype and LDL-cholesterol. ROC curves showed that the AUCs of WMH, NLR and their combination for predicting short-term prognosis of AIS patients were 0.760 [standard error (): 0.029, 95% confidence interval (): 0.703-0.817, <0.001], 0.717 (: 0.030, 95% : 0.661-0.774, <0.001) and 0.906 (: 0.019, 95% : 0.868-0.944, <0.001), respectively. The AUC of combination prediction was significantly higher than those of individual predictions (0.906 0.760, =4.211, <0.001; 0.906 vs 0.717, =5.322, <0.001).
CONCLUSION
WMH and NLR were independently associated with short-term prognosis of AIS patients, and the combination of WMH and NLR could be applied in predicting short-term prognosis of AIS patients, having a high predictive value.
目的
评估脑白质高信号（WMH）与中性粒细胞与淋巴细胞比值（NLR）相结合在预测急性缺血性脑卒中（AIS）患者短期预后中的价值。
患者与方法
本前瞻性观察性研究纳入了309例AIS患者。在AIS发病后3个月时，使用改良Rankin量表（mRS）评分对他们进行评估。mRS评分为0 - 2被定义为良好预后，而mRS评分为3 - 6被定义为不良预后。采用多因素分析来确定WMH和NLR与AIS患者短期预后的独立关联，并使用受试者工作特征（ROC）曲线来评估WMH、NLR及其组合对AIS患者短期预后的预测价值，采用检验来比较曲线下面积（AUC）。
结果
在309例AIS患者中，201例（65.0%）在3个月时有良好预后，而108例（35.0%）有不良预后。根据多因素分析结果，在调整了糖尿病、心房颤动、TOAST亚型和低密度脂蛋白胆固醇后，WMH、NLR和入院时美国国立卫生研究院卒中量表（NIHSS）评分与AIS不良预后独立相关。ROC曲线显示，WMH、NLR及其组合预测AIS患者短期预后的AUC分别为0.760[标准误（SE）：0.029，95%置信区间（CI）：0.703 - 0.817，P<0.001]、0.717（SE：0.030，95%CI：0.661 - 0.774，P<0.001）和0.906（SE：0.019，95%CI：0.868 - 0.944，P<0.001）。联合预测的AUC显著高于单独预测的AUC（0.906对0.760，Z = 4.211，P<0.001；0.906对0.717，Z = 5.322，P<0.001）。
结论
WMH和NLR与AIS患者短期预后独立相关，WMH与NLR的组合可用于预测AIS患者的短期预后，具有较高的预测价值。
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