白细胞计数、中性粒细胞比率和红细胞沉降率与急性脑梗死结局的关系

叶家楷; 张金涛; 孔艳; 许锬; 邹婷婷; 张永红; 张绍艳

Abstract

叶家楷,张金涛,孔艳,许锬,邹婷婷,张永红,张绍艳.白细胞计数、中性粒细胞比率和红细胞沉降率与急性脑梗死结局的关系[J].Chinese journal of Epidemiology,2012,33(9):956-960

白细胞计数、中性粒细胞比率和红细胞沉降率与急性脑梗死结局的关系

Relationship between white blood cell count, neutrophils ratio and erythroeyte sedimentation rate and short clinical outcomes among patients with acute ischemic stroke at hospital admission

Received:April 11, 2012

DOI：10.3760/cma.j.issn.0254-6450.2012.09.018

KeyWord: 脑梗死白细胞计数中性粒细胞比率红细胞沉降率

English Key Word: Stroke White blood cell count Neutrophils ratio Erythrocyte sedimentation rate

FundProject:

Author Name	Affiliation	E-mail
Ye Jia-kai	Department of Epidemiology, School of Public Health, Medical College of Soochow University, Suzhou 215123, China
Zhang Jin-tao	The 88^th Hospital of Jinan Military Command
Kong Yan	The 88^th Hospital of Jinan Military Command
Xu Tan	Department of Epidemiology, School of Public Health, Medical College of Soochow University, Suzhou 215123, China
Zou Ting-ting	The 88^th Hospital of Jinan Military Command
Zhang Yong-hong	Department of Epidemiology, School of Public Health, Medical College of Soochow University, Suzhou 215123, China
Zhang Shao-yan	Department of Epidemiology, School of Public Health, Medical College of Soochow University, Suzhou 215123, China	zhangsy@suda.edu.cn

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Abstract:

目的探讨急性脑梗死患者入院时白细胞计数、中性粒细胞比率和红细胞沉降率与住院期间不良结局的关系。方法以2675例急性脑梗死患者为研究对象，收集人几统计学信息、生活方式和病史相关资料及白细胞引数、中性粒细胞比率和红细胞沉降率等实验室检查结果。将出院时神经功能评分≥5或住院期间死亡定义为不良结局。采用非条件logistic回归方法进行统计分析。结果急性脑梗死患者有研究结局组的白细胞训数、中性粒细胞比率和红细胞沉降率均高于无研究结局组，差异均有统计学意义(P9/L者相比，≥8.7×10⁹/L者发生不良结局的OR值(95%CI)为1.883(1.306～2.716)；与中性粒细胞比率≤0.56者相比，O.57～0.64和≥O.74者发生不良结局的OR值(95%Cl)依次为1.572 (1.002～2.466)和2.577 (1.698～3.910)；与红细胞沉降率≤4mm/h者相比，≥17mm/h者发生不良结局的OR值(95%Cl)为2.426 (1.233～4.776）。随着入院时白细胞计数和中性粒细胞比率的升高，发生不良结局的危险性也随之增加，线性趋势性检验PO.05。结论急性脑梗死患者入院时白细胞计数、中性粒细胞比率和红细胞沉降率与住院期间不良结局有关。随着入院白细胞计数和中性粒细胞比率水平的升高，住院期间发生不良结局的危险性也相应升高。

English Abstract:

Objective To investigate the relationship between white blood cell count, nentrophils ratio and erythroeyte sedimentation rate and short outcomes among patients with acute ischemic stroke at admission to the hospital. Methods A total of 2675 acute ischemic stroke patients were included in this study. Data on demographic characteristics, life stylc, history of disease, white blood cell count(WBC), neutrophils ratio(NEUR), erythroeyte sedimentation rate(ESR) and clinical outcomes were collected for a11 the participants. Poor clinical outcome was defined as neurologic deficiency (NIHSS≥5) at discharge or death during hospitalization. Results White blood cell count, nentrophils ratio and erythroeyte sedimentation rate were higher in patients with poor outcome than in those without clinical outcome. According to the quartile range, WBC, NEUR and ESR were divided into four 1evels at admission. After adjustment for multivariate, compared with WBC≤5.6×10⁹/L, the odds ratio (95% confidence intervals) of poor outcome with≥8.7×10⁹/L was l.883 (1.306-2.716). When compared with NEUR≤0.56, the odds ratio (95% confidence intervals) of poor outcomc with 0.57-0.64 and with≥0.74 were l.572(1.002-2.466) and 2.577(1.698-3.910). respectively. When compared with ESR≤4 mm/h, the odds ratio (95% confidence intervals) of poor outcome with≥17 mm/h was 2.426(1.233-4.776). Elevated WBC count and NEUR at admission were significantly and positively associated with poor clinical outcomes among patients with acute ischemic stroke (trend test P< 0.05). Elevated ESR was not significantly or positively associated wich poor clinical outcomes among patients with acute ischemic stroke (trend test P> 0.05). Conclusion There appeared associations between WBC, NEUR, ESR and poor outcome among patients with acute ischemic stroke at admission to the hospital. Both elevated WBC count and NEUR showed significantly positive association with poor clinical outcomes among patients with acute ischemic stroke at admission.

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