文章摘要
血小板/淋巴细胞比值与老年急性缺血性脑卒中患者静脉溶栓后出血转化及近期预后的相关性
The correlation between platelet/lymphocyte ratio and bleeding transformation and short-term prognosis after intravenous thrombolysis in elderly patients with acute ischemic stroke
投稿时间:2024-07-12  修订日期:2024-07-12
DOI:
中文关键词: 血小板和淋巴细胞比值  急性缺血性脑卒中  静脉溶栓  出血转化  预后
英文关键词: Platelet/lymphocyte ratio  Acute ischemic stroke  Intravenous thrombolysis  Hemorrhagic tromsformation  Prognosis
基金项目:普洱市人民医院院内科研项目,项目编号:2023YN03
作者单位邮编
郭莺 云南省普洱市人民医院 665000
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中文摘要:
      目的:探讨老年急性缺血性脑卒中(AIS)患者血小板和淋巴细胞比值(PLR)与rt-PA静脉溶栓后出血转化(HT)及近期预后的相关性。方法:选取132例老年AIS患者为研究对象,依据静脉溶栓后是否发生HT分为HT组(n=21)、非HT组(n=111)。比较两组一般资料、实验室指标。Logistic回归分析静脉溶栓后HT的影响因素,受试者工作特征曲线(ROC)分析PLR对rt-PA静脉溶栓后HT的预测价值,对比不同水平PLR患者90d神经功能预后差异。结果:HT组NIHSS评分、发病至溶栓时间、心房颤动史、PLT、PLR均高于非HT组,LYW低于非HT组(P<0.05)。两组性别、年龄、BMI、病变部位、吸烟、饮酒、冠心病、高血压病、糖尿病、卒中或TIA史、SBP、DBP、FBG、Hcy、TG、TC、LDL-C、HDL-C、RBC、WBC比较无统计学差异(P>0.05)。AIS患者rt-PA静脉溶栓后HT的危险因素包括NIHSS评分、发病至溶栓时间、心房颤动及PLR。PLR预测AIS患者静脉溶栓后HT的截断值为147.415,曲线下面积为0.807,灵敏度为76.2%,特异度为82.9%。高PLR组90d神经功能预后不良发生率高于低PLR组(P<0.05)。结论:PLR与老年AIS患者静脉溶栓后HT和预后不良相关,对HT有较好的预测价值。
英文摘要:
      Objective:To evaluate the correlation between platelet/lymphocyte ratio(PLR)with hemorrhagic tromsformation(HT)and prognosis in elderly patient with acute ischemic stroke(AIS)after rt-PA intravenous thrombolysis. Methods:132 elderly AIS patients were selected as the study objects, divided into HT group (n=21) and non-HT group (n=111) according to whether HT occurred. The general data and laboratory indicators were compared between two groups. Logistic regression was used to analyze the influencing factors of HT after intravenous thrombolytic therapy, and ROC was used to analyze the predictive value of PLR for HT after intravenous thrombolytic therapy. The difference in 90d neurological function prognosis of patients with different levels of PLR was compared. Results:The NIHSS score, time from onset to thrombolysis, atrial fibrillation, PLT and PLR of HT group were higher than non-HT group, and LYW was lower than non-HT group(P<0.05). There were no significant differences in gender, age, BMI, lesion site, smoking, drinking, coronary heart disease, hypertension, diabetes, stroke or TIA history, SBP, DBP, FBG, Hcy, TG, TC, LDL-C, HDL-C, RBC and WBC between two groups(P>0.05). Logistic regression analysis showed that NIHSS score, time from onset to thrombolysis, atrial fibrillation and PLR were risk factors for HT after intravenous thrombolysis in AIS patients. ROC curve analysis results showed that PLR predicted the truncation value of HT after intravenous thrombolysis in AIS patients was 147.415, the area under the curve was 0.807, the sensitivity was 76.2%, and the specificity was 82.9%. The incidence of poor neurological function prognosis at 90 days in the high PLR group was higher than low PLR group(P<0.05). Conclusion:PLR is associated with poor prognosis and HT of elderly AIS patients after rt-PA intravenous thrombolysis, and has good predictive value for HT.
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