中国实用神经疾病杂志2025，Vol.28Issue(3)：294-299,6.DOI:10.12083/SYSJ.241012
WORSEN评分联合中性粒细胞与淋巴细胞比值对进展性卒中的预测价值
Predictive value of WORSEN score combined with neutrophil to lymphocyte ratio for progressive stroke
摘要
Abstract
Objective To investigate the predictive value and significance of WORSEN score combined with neutrophil to lymphocyte ratio in progressive stroke patients.Methods The data of 300 cerebral infarction patients who received non-early reperfusion treatment in Department of Neurology,Nanjing Jiangning Hospital within 24 hours of onset from September 2021 to December 2022 were retrospectively studied.The patients were divided into non-progressive stroke group and progressive stroke group according to whether early neurological function deterioration occurred during hospitalization.Univariate analysis was performed on the data of the two groups.Multivariate Logistic regression analysis was used to explore the risk factors for progressive stroke treated with medical management.Receiver operating characteristics(ROC)curves were used to analyze WORSEN score combined with NLR in the prediction of progressive stroke.The WORSEN score consists of wrong(poor)blood sugar control(W),old myocardial infarction(O),radiological findings(R),infarct size(S),elevated low-density lipoprotein cholesterol(E)and neurological findings(N).Results Among 300 patients with cerebral infarction,82 cases showed progressive stroke and 218 cases were non-progressive stroke.The proportion of initial single antiplatelet use,NLR,blood glucose,fibrinogen degradation product(FDP),free triiodothyronine(FT3),NIHSS score at admission,WORSEN score,internal carotid artery occlusion,M1 segment occlusion of middle cerebral artery and proportion of striatum infarction in the progressive stroke group were all higher than those in the non-progressive stroke group.The proportion of hypertension,blood pressure variability within 24 hours of admission,blood urine nitrogen and creatinine were lower than those in the non-progressive group.All the differences were statistically significant(P＜0.05),while there were no statistically significant differences among the remaining factors(P＞0.05).Multivariate Logistic regression analysis showed that NLR(OR=1.08,95％CI:1.03-1.13),M1 segment occlusion of middle cerebral artery(OR=1.57,95％CI:1.12-2.19),striatal infarction(OR=2.16,95％CI:1.30-3.60)and infarct diameter of 15 to 30 mm(OR=1.81,95％CI:1.08-3.03)were independent risk factors for progressive stroke.ROC curve analysis showed that when the truncation value of WORSEN scores combined with NLR was 1.50,the corresponding sensitivity and specificity for predicting progressive stroke were 88.3％and 43.4％,respectively.The area under the ROC curve was 0.71(95％CI:0.66-0.77,P＜0.05).Conclusion Acute cerebral infarction patients with high WORSEN scores and high NLR should be highly regarded.The WORSEN score combined with NLR may be valuable tool in the detection of progressive stroke.关键词
进展性卒中/WORSEN评分/中性粒细胞/淋巴细胞比值/早期神经功能恶化/危险因素/预测价值Key words
Progressive stroke/WORSEN score/Neutrophil to lymphocyte ratio/Early neurological deterioration/Risk factors/Predictive value分类
临床医学引用本文复制引用
杜诚,孔德莲,韦存胜,俞晓蓉,陈校文..WORSEN评分联合中性粒细胞与淋巴细胞比值对进展性卒中的预测价值[J].中国实用神经疾病杂志,2025,28(3):294-299,6.基金项目
2023年度开放课题研究项目(编号:JSHD202307) （编号:JSHD202307）
