NLR、PLR、hs-CRP、Hb、D-D与急性脑梗死非溶栓治疗后出血性转化的相关性分析

目的探讨中性粒细胞与淋巴细胞比值(NLR)、血小板/淋巴细胞比值(PLR)、超敏C反应蛋白(hs-CRP)、血红蛋白(Hb)、D-二聚体(D-D)与急性脑梗死非溶栓治疗后出血性转化的相关性。方法回顾性选取2015年1月至2019年12月安徽医科大学附属六安医院收治的80例急性脑梗死非溶栓治疗后出血性转化患者为观察组,另参照观察组基线资料选取同期急性脑梗死非溶栓治疗后无出血性转化患者60例为对照组。采用改良Rankin量表(mRS)评价患者3个月后的转归情况并分为转归良好组(n=56)和转归不良组(n=24)。对比分析NLR、PLR、hs-CRP、Hb、D-D水平。分析观察组患者mRS评分与NLR、hs-CRP、Hb、D-D相关性。结果2组患者的PLR水平比较(122.06±30.04 vs.130.55±30.50),差异无统计学意义(P>0.05);观察组患者的NLR、hs-CRP水平为(7.22±1.90)、(13.10±3.04)mg/L,均显著高于对照组(6.02±1.88)、(7.30±2.04)mg/L],观察组Hb、D-D水平为(120.60±24.10)g/L、(296.26±32.24)μg/L,均显著低于对照组(141.30±20.05)g/L、(336.20±34.10)μg/L],差异有统计学意义(P<0.05)。转归不良患组NLR、hs-CRP水平为(7.98±2.14)、(16.96±4.16)mg/L,均显著高于预后良好患者(6.89±2.03)、(11.45±3.03)mg/L],Hb水平(120.60±24.10)g/L显著低于预后良好组(141.30±20.05)g/L,差异有统计学意义(P<0.05),PLR、D-D比较(134.20±32.66 vs.128.98±31.05)、(285.20±35.10)μg/L vs.(301.01±36.26)μg/L],差异无统计学意义(P>0.05)。急性脑梗死非溶栓治疗后出血性转化患者mRS评分与NLR、hs-CRP呈显著正相关性(r=0.722、0.614),与Hb呈显著负相关性(r=-0.609),差异有统计学意义(P<0.05)。结论急性脑梗死非溶栓治疗后出血性转化患者的NLR、hs-CRP升高,Hb、D-D下降,而PLR无显著变化,其中急性脑梗死非溶栓治疗后出血性转化患者mRS评分与NLR、hs-CRP呈显著正相关性,与Hb呈显著负相关性,NLR、hs-CRP、Hb可能在预测此类患者预后方面具有较高的临床价值。

Correlation analysis of NLR,PLR,hs-CRP,Hb,D-D and hemorrhagic transformation after non-thrombolytic therapy for acute cerebral infarction

Objective To explore the ratio of neutrophil to lymphocyte(NLR),platelet/lymphocyte ratio(PLR),hypersensitive C-reactive protein(hs-CRP),Hb(hemoglobin),D-dimer(DD)and correlation of hemorrhagic transformation after non-thrombolytic therapy for acute cerebral infarction.Methods A retrospective selection of 80 patients with acute cerebral infarction with hemorrhagic transformation after non-thrombolytic treatment from January 2015 to December 2019,who were admitted to the Lu'an People's Hospital of Anhui Medical University,was selected as the observation group.Sixty patients without hemorrhagic transformation after non-thrombolytic treatment of cerebral infarction served as the control group.The modified Rankin Scale(mRS)was used to evaluate the outcome of patients after 3 months and were divided into a good outcome group(n=56)and a poor outcome group(n=24),and a comparative analysis of NLR,PLR,hs-CRP,Hb,DD level.The correlation between mRS score and NLR,hs-CRP,Hb,D-D of the observation group was analyzed.Results The PLR comparison between the two groups of patients(122.06±30.04 vs.130.55±30.50),the difference was not statistically significant(P>0.05).The observation group's NLR(7.22±1.90),hs-CRP(13.10±3.04)mg/L]were significantly higher than the control group(6.02±1.88),(7.30±2.04)mg/L],Hb(120.60±24.10)g/L]and DD(296.26±32.24)μg/L in the observation group were significantly lower than those in the control group(141.30±20.05)g/L and(336.20±34.10)μg/L],the differences were statistically significant(P<0.05).The levels of NLR and hs-CRP in the poor prognosis group were(7.98±2.14)and(16.96±4.16)mg/L,which were significantly higher than those with good prognosis group(6.89±2.03),(11.45±3.03)mg/L,],Hb level(120.60±24.10)g/L was significantly lower than the good prognosis group(141.30±20.05)g/L,the differences were statistically significant(P<0.05),and there was no significant difference between PLR and D-D(134.20±32.66 vs.128.98±31.05),(285.20±35.10)μg/L vs.(301.01±36.26)μg/L,P>0.05].The mRS score of patients with hemorrhagic transformation after non-thrombolytic treatment of acute cerebral infarction showed a significant positive correlation with NLR and hs-CRP(r=0.722,0.614),and a significant negative correlation with Hb(r=-0.609),and the difference was statistically significant(P<0.05).Conclusion After non-thrombolytic treatment of acute cerebral infarction,NLR and hs-CRP of patients with hemorrhagic transformation increased,Hb,DD decreased,but PLR did not change significantly.Among them,the mRS score of patients with hemorrhagic transformation after non-thrombolytic treatment of acute cerebral infarction was similar to NLR and hs-CRP.Significantly positive correlation,significant negative correlation with Hb,NLR,hs-CRP,Hb may have high clinical value in predicting the prognosis of such patients.