摘要
Abstract
Objective To investigate the predictive effect of red blood cell distribution width (RDW) on the prognosis of intravenous thrombolysis in patients with acute ischemic stroke (AIS). Methods From August 2014 to July 2017,163 consecutive patients with AIS treated with recombinant tissue type plasminogen activator (rt-PA) intravenous thrombolysis within 4.5 h after onset at the Stroke Unit,Department of Neurology,the First Affiliated Hospital of Harbin Medical University were analyzed retrospectively.According to the inclusion and exclusion criteria,108 patients were included in the study actually.Among them,24 were females and 84 were males.They were divided into either a good prognosis group (n=79,mRS≤2) or a poor prognosis group (n=29,mRS>2) according to the modified Rankin scale(mRS) at 3 months of follow-up after thrombolysis.The basic data of all patients were collected,including age,sex,past medical history,and personal history.Venous blood was collected within 24 h after admission,and RDW and other hematological indexes were measured.The national institutes of health stroke scale (NIHSS)score and mRS score were documented on admission.The mRS was used to conduct prognostic score of the patients at 3 months after the onset.Multiple factor logistic regression model was used to analyze the risk factors and the receiver operating characteristic (ROC) curve was used to analyze the predictive effect of RDW on the thrombolytic outcome of the patients. Results (1) Compared with the good prognosis group,the NIHSS score on admission,baseline blood glucose and RDW levels were higher in patients of the poor prognosis group.There were significant differences between the two groups(all P<0.05).There were no significant differences in other previous diseases and baseline characteristics between the two groups(all P>0.05). (2) Multifactor logistic regression analysis showed that the increased NIHSS score (OR, 1.209,95% CI 1.094-1.337),baseline blood glucose (OR,1.327,95% CI 1.073-1.641),and RDW (OR,1.701,95% CI 1.030-2.810) on admission were the independent risk factors for poor prognosis at 3 months after admission in patients with AIS (all P <0.05). (3) The analysis of RDW cut-off value (ROC) for predicting poor prognosis at 3 months showed that the area under curve (AUC) was 0.651 (95% CI 0.530-0.771;P =0.017),and the best predictive value of RDW was 12.2% (sensitivity 51.7%,specificity 77.2%). Conclusions RDW is an independent predictor of the prognosis of rt-PA intravenous thrombolysis in patients with AIS. High level of RDW indicates that the patients have poor recovery of nerve function,and the prognosis is poor.关键词
急性缺血性卒中/红细胞分布宽度/静脉溶栓/预后/预测作用Key words
Acute ischemic stroke/Red blood cell distribution width/Intravenous thrombolysis/Prognosis/Prognostic effect
