Zhongguo cuzhong zazhi (Sep 2024)
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
Abstract
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。 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.
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