嗜酸性粒细胞与单核细胞比值预测急性缺血性卒中患者静脉溶栓预后的价值研究

doi:10.3969/j.issn.1673-5765.2024.09.007

中国卒中杂志 ›› 2024, Vol. 19 ›› Issue (9): 1025-1033.DOI: 10.3969/j.issn.1673-5765.2024.09.007

嗜酸性粒细胞与单核细胞比值预测急性缺血性卒中患者静脉溶栓预后的价值研究

王晓蕊¹，骆嵩¹，邹良玉²，屈洪党¹，崔雪¹，赵玉洁¹

1 蚌埠 233004 蚌埠医科大学第一附属医院神经内科 2 暨南大学第二临床医学院神经内科

收稿日期:2023-12-18 出版日期:2024-09-20 发布日期:2024-09-20
通讯作者: 骆嵩 542462407@qq.com
基金资助:
安徽省临床医学研究转化专项项目（202304295107020076）

安徽省教育厅重点项目（2022AH051480）

安徽省“江淮名医”培育工程项目（2022）

蚌埠市科技创新指导类项目（20230131）

安徽省教育厅重点项目（KJ2019A0364）

Value of Eosinophil-to-Monocyte Ratio in Predicting the Prognosis of Patients with Acute Ischemic Stroke Receiving Intravenous Thrombolysis

WANG Xiaorui¹, LUO Song¹, ZOU Liangyu², QU Hongdang¹, CUI Xue¹, ZHAO Yujie¹

1 Department of Neurology, The First Affiliated Hospital of Bengbu Medical University, Bengbu 233004, China;
2 Department of Neurology, 2nd Clinical Medical College of Jinan University, Shenzhen 518020, China

Received:2023-12-18 Online:2024-09-20 Published:2024-09-20
Contact: LUO Song, E-mail: 542462407@qq.com

摘要/Abstract

摘要：

目的探讨嗜酸性粒细胞与单核细胞比值（eosinophil-to-monocyte ratio，EMR）与接受静脉溶栓治疗的急性缺血性卒中（acute ischemic stroke，AIS）患者预后的关系。

方法收集蚌埠医科大学第一附属医院于2021年1月—2022年12月收治的211例接受静脉溶栓治疗的AIS患者的临床资料，根据3个月mRS评分分为预后良好（mRS评分≤2分）组和预后不良（mRS评分＞2分）组，根据生存状态分为生存组与死亡组。采用单因素及多因素logistic回归分析评估EMR与AIS静脉溶栓患者预后的关系；采用ROC曲线对EMR、中性粒细胞与淋巴细胞比值（neutrophil-to-lymphocyte ratio，NLR）、血小板与淋巴细胞比值（platelet-to-lymphocyte ratio，PLR）的预测准确率进行比较。依据ROC曲线的最佳截断值将患者分为高EMR组与低EMR组，分析EMR水平与预后的关系。

结果多因素logistic回归分析显示EMR（OR 0.406，95%CI 0.277～0.597，P＜0.001）与AIS静脉溶栓患者的不良预后独立相关。ROC曲线显示EMR的AUC为0.773（95%CI 0.711～0.836，P＜0.001），优于NLR、PLR，最佳截断值为0.435，灵敏度为90.2%，特异度为55.8%。高EMR组（81例）的预后不良率（P＜0.001）和死亡率（P=0.009）与低EMR组（130例）相比均降低。

结论在接受静脉溶栓治疗的AIS患者中，较低的EMR与3个月不良预后独立相关。

文章导读： 本研究通过回顾性分析发现，嗜酸性粒细胞与单核细胞比值是急性缺血性卒中静脉溶栓患者不良预后的独立影响因素，其预测效果优于中性粒细胞与淋巴细胞比值、血小板与淋巴细胞比值。

关键词: 急性缺血性卒中; 嗜酸性粒细胞与单核细胞比值; 静脉溶栓; 预后

Abstract:

Objective To investigate the relationship between eosinophil-to-monocyte ratio (EMR) and the prognosis of patients with acute ischemic stroke (AIS) receiving intravenous thrombolysis .

Methods The clinical data of 211 patients with AIS who received intravenous thrombolysis were collected from the First Affiliated Hospital of Bengbu Medical University from January 2021 to December 2022. The patients were divided into the good prognosis (mRS score≤2 points) group and the poor prognosis (mRS score>2 points) group according to the mRS score after 3 months. They were divided into the survival group and the death group according to their survival status. Univariate and multivariate logistic regression analysis were used to evaluate the relationship between EMR and the prognosis of patients with AIS receiving intravenous thrombolysis. ROC curve was used to compare the prediction accuracy of EMR, neutrophil-to-lymphocyte ratio (NLR), and platelet-to-lymphocyte ratio (PLR). According to the optimal cut-off value of the ROC curve, patients were divided into the high EMR group and the low EMR group to analyze the relationship between EMR level and the prognosis.

Results Multivariate logistic regression analysis showed that EMR (OR 0.406, 95% CI 0.277-0.597, P<0.001) was independently associated with poor prognosis in AIS patients receiving intravenous thrombolysis. The ROC curve showed that the AUC of EMR was 0.773 (95%CI 0.711-0.836, P<0.001), which was superior to NLR and PLR. Its optimal cut-off value was 0.435, the sensitivity was 90.2%, and the specificity was 55.8%. The poor prognosis (P<0.001) and mortality (P=0.009) of the high EMR group (81 cases) were reduced compared to the low EMR group (130 cases).

Conclusions Lower EMR was independently associated with poor prognosis at 3 months in AIS patients receiving intravenous thrombolysis.

Key words: Acute ischemic stroke; Eosinophil-to-monocyte ratio; Intravenous thrombolysis; Prognosis

中图分类号:

王晓蕊, 骆嵩, 邹良玉, 屈洪党, 崔雪, 赵玉洁.

嗜酸性粒细胞与单核细胞比值预测急性缺血性卒中患者静脉溶栓预后的价值研究 [J]. 中国卒中杂志, 2024, 19(9): 1025-1033.

WANG Xiaorui, LUO Song, ZOU Liangyu, QU Hongdang, CUI Xue, ZHAO Yujie. Value of Eosinophil-to-Monocyte Ratio in Predicting the Prognosis of Patients with Acute Ischemic Stroke Receiving Intravenous Thrombolysis[J]. Chinese Journal of Stroke, 2024, 19(9): 1025-1033.

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嗜酸性粒细胞与单核细胞比值预测急性缺血性卒中患者静脉溶栓预后的价值研究

Value of Eosinophil-to-Monocyte Ratio in Predicting the Prognosis of Patients with Acute Ischemic Stroke Receiving Intravenous Thrombolysis

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