NLR联合ASPECT评分对急性大血管闭塞性 卒中静脉溶栓患者预后的评估价值.

Objective To evaluate the prognostic value of neutrophil/lymphocyte ratio (NLR) combined with Alberta Stroke Program Early CT (ASPECT) score in patients with acute ischemic stroke with large vessel occlusion (AIS-LVO) treated with intravenous thrombolytic therapy. Methods Totally 161 patients with AIS-LVO who received intravenous thrombolytic therapy were retrospectively selected. Laboratory, imaging and clinical data were collected to obtain NLR and ASPECT score. According to the modified Rankin scale (mRS) score 90 days after onset, the patients were divided into the poor prognosis group (90 cases) and good prognosis group (71 cases) . The clinical data results of the two groups were compared. We analyzed the relationship between NLR, ASPECT score and poor neurological prognosis in patients with AIS-LVO, and the value of NLR and ASPECT score in predicting poor neurological prognosis. Results Age, proportion of atrial fibrillation, proportion of collateral circulation grade 0-1, NIHSS score on admission, proportion of vascular recanalization failure, proportion of intracranial hemorrhage and preoperative NLR in the poor prognosis group were higher than those in the good prognosis group (all P<0. 05), but preoperative ASPECT score was lower than that of the good prognosis group (P<0. 05) . Logistic regression analysis showed that grade 0-1 of collateral circulation, vascular recanalization failure, preoperative ASPECT score<7, and preoperative NLR≥1. 86 were the risk factors for poor prognosis in patients with AIS-LVO afterintravenous thrombolytic therapy (all P<0. 05) . The cut-off value of NLR and ASPECT score in predicting poor prognosis of AIS-LVO patients after intravenous thrombolytic therapy was 1. 89 and 7 points, and the area under the curve was 0. 726 and 0. 783, respectively. The area under the curve of NLR combined with ASPECT score in predicting poor prognosis was 0. 923, which were higher than that of NLR or ASPECT score alone (Z=4. 772, 4. 207, both P< 0. 05) . Conclusion High NLR and low ASPECTS score are associated with poor prognosis of AIS-LVO patients after intravenous thrombolytic therapy, and NLR combined ASPECTS score can better predict the occurrence of poor prognosis after intravenous thrombolytic therapy of AIS-LVO patients. [ABSTRACT FROM AUTHOR]