广东医学2024，Vol.45Issue(5)：583-589,7.DOI:10.13820/j.cnki.gdyx.20240278
血清NLR联合AGI分级对急性缺血性卒中患者血管内治疗临床结局的预测价值
Establishment of a serum NLR combined with AGI grading model to predict clinical outcomes in patients with acute ischemic stroke undergoing endovascular treatment
摘要
Abstract
Objective To investigate the predictive value of neutrophil-to-lymphocyte ratio(NLR)combined with Acute Gastrointestinal Injury(AGI)grading for the clinical outcomes of patients with acute ischemic stroke(AIS)undergoing endovascular treatment(EVT).Methods A retrospective analysis was conducted on AIS patients treated with EVT at a stroke center.Patients were categorized into good prognosis group(mRS≤2)and poor prognosis group(mRS＞2)based on Modified Rankin Scale(mRS)scores 90 days post-surgery.Clinical data and TCM syndrome dif-ferentiation were collected for both groups.Preoperative NLR was calculated,and the highest AGI grade within 1 week of admission was recorded for statistical analysis.Risk factors for poor prognosis after EVT in AIS patients were studied,and logistic regression was employed for analysis.Receiver operating characteristic(ROC)curves were also plotted to evaluate the predictive value of NLR combined with AGI grading for the prognosis of AIS patients undergoing EVT.Results A to-tal of 164 patients were included,with 89(54.3％)in the good prognosis group and 75(45.7％)in the poor prognosis group.Patients in the poor prognosis group had higher age,NIH Stroke Scale(NIHSS)scores at admission,total hospi-talization costs,prevalence of hypertension,triglyceride levels,urea levels,NLR levels,incidence of pneumonia,and AGI grade compared to those in the good prognosis group(all P＜0.05).The proportion of stroke phlegm obstruction syn-drome was higher in the poor prognosis group than in the survival group(P＜0.05).Multivariable logistic regression anal-ysis showed that NLR(OR=1.121,95％CI:1.025-1.227,P=0.012),severity of AGI(OR=1.936,95％CI:1.233-3.040,P=0.004),urea levels(OR=1.343,95％CI:1.036-1.741,P=0.026),stroke phlegm obstruc-tion syndrome(OR=3.335,95％CI:1.136-9.568,P=0.025),and occurrence of pneumonia(OR=4.529,95％CI:1.444-14.210,P=0.010)were independent risk factors for poor outcomes after EVT in AIS patients.ROC curve analysis showed that the area under the curve for the combined evaluation of NLR and AGI grading in predicting poor prog-nosis after EVT in patients with acute ischemic stroke was greater than that for NLR or AGI grading alone.Conclusion NLR and AGI have certain predictive value for the prognosis evaluation of AIS patients undergoing EVT,and their combi-nation can enhance the predictive value.关键词
急性缺血性卒中/血管内治疗/中性粒细胞/淋巴细胞比值/急性胃肠损伤分级/预后Key words
acute ischemic stroke/endovascular treatment/neutrophil-to-lymphocyte ratio/acute gastroin-testinal injury classification/prognosis分类
医药卫生引用本文复制引用
范文定,梁泳彤,吴曦,苏懿,吴清玉,吴智鑫,魏思源,丘富程,凌皓,李灵知..血清NLR联合AGI分级对急性缺血性卒中患者血管内治疗临床结局的预测价值[J].广东医学,2024,45(5):583-589,7.基金项目
国家自然科学基金项目(82374216) （82374216）
广东省中医药局科研项目(20241307) （20241307）
广东省医学科研基金项目(A2023198) （A2023198）
佛山市自筹经费类科技创新项目(2220001005576) （2220001005576）
佛山市卫生健康局医学科研课题(20240720A010143) （20240720A010143）
