血细胞参数及凝血功能指标预测急性脑梗死患者溶栓预后的价值

doi:10.3969/j.issn.1671-7171.2023.09.011

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Abstract 【Objective】To explore the value of blood cell parameters and coagulation function indicators in predicting the thrombolytic prognosis of patients with acute cerebral infarction (ACI).【Methods】A total of 200 patients with ACI admitted to two hospitals were given rt-PA intravenous thrombolytic therapy. After one month of treatment,patients were divided into a good prognosis group (mRS score ≤2,114 cases) and a poor prognosis group (mRS score >2,86 cases) based on the modified Rankin Scale (mRS) score. The independent risk factors affecting the short-term prognosis of ACI patients treated with thrombolysis were analyzed,including blood cell parameters [red cell distribution width (RDW),platelet distribution width (PDW),platelet/lymphocyte ratio (PLR),and neutrophil/lymphocyte ratio (NLR)],and coagulation function indicators [thrombin time (TT),prothrombin time (PT),activated partial thromboplastin time (APTT),fibrinogen (FIB),D-dimer (D-D)]. The receiver operating characteristic curve (ROC) was used to evaluate the predictive efficacy of these parameters for the short-term prognosis.【Results】The proportion of atrial fibrillation,fasting blood glucose,and NIH Stroke Scale (NIHSS) score in the poor prognosis group were higher than those in the good prognosis group (P<0.05). RDW,PLR,NLR,FIB,and D-D in the poor prognosis group were higher than those in the good prognosis group (P<0.05),while TT in the poor prognosis group was lower than that in the good prognosis group (P<0.05). there was no statistically significant difference in PDW,PT,and APTT levels between the two groups (P>0.05). Multivariate Logistic regression analysis showed that,in addition to atrial fibrillation,fasting blood glucose,and NIHSS score,RDW,PLR,NLR,and D-D were independent risk factors affecting the short-term prognosis of ACI patients treated with thrombolysis (P<0.05). ROC curve analysis showed that RDW,PLR,NLR,and D-D had certain predictive efficacy for the short-term prognosis of ACI patients after thrombolysis,with areas under the curve (AUC) of 0.725,0.791,0.798,and 0.784,respectively; the combined AUC for predicting the short-term prognosis was 0.945.【Conclusion】RDW,PLR,NLR,and D-D are independent risk factors affecting the short-term prognosis of ACI patients after thrombolysis,and the combination of these four parameters can serve as sensitive predictive indicators for their short-term prognosis.

Key words： Brain Infarction Acute Disease Erythrocyte Indices Prothrombin Time Prognosis

Received: 18 November 2022

PACS:

R743.33

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	WANG Qianhui
	YU Yonghui

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WANG Qianhui,YU Yonghui. Value of Blood Cell Parameters and Coagulation Function Indicators in Predicting Thrombolytic Prognosis of Acute Cerebral Infarction Patients[J]. JOURNAL OF CLINICAL RESEARCH, 2023, 40(9): 1319-1323.

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http://journal07.magtech.org.cn/yxlcyj/EN/10.3969/j.issn.1671-7171.2023.09.011 OR http://journal07.magtech.org.cn/yxlcyj/EN/Y2023/V40/I9/1319

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