中国实用神经疾病杂志2025，Vol.28Issue(6)：689-694,6.DOI:10.12083/SYSJ.231794
NLR SHR及联合指标预测静脉溶栓治疗急性缺血性脑卒中患者预后的价值
Predictive value of NLR,SHR and combined indicators for the prognosis of patients with acute ischemic stroke undergoing intravenous thrombolysis
摘要
Abstract
Objective To investigate the predictive value of neutrophil to lymphocyte ratio(NLR),stress hyperglycemia ratio(SHR)in evaluating 90-day prognosis of patients with acute ischemic stroke(AIS)receiving intravenous thrombolysis.Methods AIS patients who underwent intravenous thrombolysis at the emergency green channel from December 2020 to December 2022 were retrospectively included.The prognosis was evaluated based on the modified Rankin scale(mRS)score after 90 days.The favorable prognosis was based on mRS score of 0-2,and unfavorable prognosis was based on mRS score of 3-6.The baseline clinical data,calculate NLR,lymphocyte/monocyte ratio(LMR),and SHR were collected.The univariate analysis and multivariate Logistic regression were performed to assess the risk factors for prognosis,the receiver operating characteristic(ROC)curve was used to analyze predictive value of NLR,SHR and combined indicators for the prognosis of patients with AIS undergoing intravenous thrombolysis.Results Totally 209 patients were enrolled,including 60 cases(28.7%)in unfavorable prognosis group and 149 cases(71.3%)in favorable prognosis group.The univariate analysis represented that there were statistically differences in age,history of atrial fibrillation,SHR,NLR,creatinine,glycated hemoglobin,BNP,baseline diastolic blood pressure,and baseline NIHSS between the two groups(P<0.05).After multivariate regression analysis,NLR,SHR,age,baseline NIHSS,glycated hemoglobin were independent risk factors for unfavorable prognosis(P<0.05).The ROC curve showed that the area under the curve for predicting unfavorable prognosis by NLR and SHR was 0.618(95%CI:0.549-0.684,P<0.05)and 0.633(95%CI:0.564-0.699,P<0.05),respectively,with sensitivity of 45.00%and 60.00%,and specificity of 77.85%and 62.59%,respectively.The combined predictive value of NLR and SHR was higher than that of NLR(Z=2.246,P<0.05).Conclusion In AIS patients undergoing intravenous thrombolysis,elevated NLR and SHR are associated with unfavorable prognosis at 90-day.The combined predictive value is higher and can be used as a predictive indicator for unfavorable prognosis after AIS intravenous thrombolysis.关键词
缺血性脑卒中/静脉溶栓/预后/中性粒细胞/淋巴细胞比值/应激性高血糖比值Key words
Acute ischemic stroke/Intravenous thrombolysis/Prognosis/Neutrophil to lymphocyte ratio/Stress hyperglycemia ratio分类
临床医学引用本文复制引用
任雅芳,范文斐,刘冰,王春慧,郑世茹,付胜奇,张淑玲..NLR SHR及联合指标预测静脉溶栓治疗急性缺血性脑卒中患者预后的价值[J].中国实用神经疾病杂志,2025,28(6):689-694,6.基金项目
河南省医学科技攻关计划省部共建项目(编号:SB201903029) （编号:SB201903029）
