论文部分内容阅读
目的:探讨嗜酸性粒细胞计数与急性缺血性卒中患者短期转归的相关性。方法:回顾性纳入2017年6月至2019年6月在阜阳市人民医院住院治疗的急性缺血性卒中患者。收集患者人口统计学和基线临床资料。在出院时或发病后第14天时采用改良Rankin量表评价短期临床转归，0～2分定义为转归良好，>2分定义为转归不良。应用多变量n logistic回归分析确定短期转归不良的独立影响因素。采用受试者工作特征(receiver operating characteristics, ROC)曲线评估嗜酸性粒细胞计数对患者短期转归不良的预测价值。n 结果:共纳入急性缺血性卒中患者300例，男性187例(62.3%)，女性113例(37.7%)；年龄(63.62±12.14)岁；基线美国国立卫生研究院卒中量表(National Institutes of Health Stroke Scale, NIHSS)评分(5.48±4.85)分。转归良好组228例(76.0%)，转归不良组72例(24.0%)。单变量分析显示，转归不良组年龄、高血压、基线NIHSS评分、C反应蛋白、心房颤动和中性粒细胞计数显著高于转归良好组，而男性、吸烟、嗜酸性粒细胞计数和嗜酸性粒细胞百分比显著低于转归良好组(n P均<0.05)。多变量n logistic回归分析显示，基线NIHSS评分[优势比(odds ratio, n OR)1.726，95%置信区间(confidence interval, n CI)1.400～2.128；n P2 was defined as poor outcome. Multivariaten logistic regression analysis was used to determine the independent influencing factors of poor short-term outcome. Receiver operating characteristic (ROC) curve was used to evaluate the predictive value of eosinophil count for poor short-term outcome.n Results:A total of 300 patients with acute ischemic stroke were enrolled, including 187 males (62.3%) and 113 females (37.7%); their age was 63.62±12.14 years; baseline National Institutes of Health Stroke Scale (NIHSS) score was 5.48±4.85. Two hundred and twenty-eight patients (76.0%) had a good outcome and 72 (24.0%) had a poor outcome. Univariate analysis showed that age, hypertension, baseline NIHSS score, C-reactive protein, atrial fibrillation, and neutrophil count of the poor outcome group were significantly higher than those of the good outcome group, while male, smoking, eosinophil count and percentage of eosinophils were significantly lower than those of the good outcome group (all n P<0.05). Multivariaten logistic regression analysis showed that baseline NIHSS score (odds ratio [n OR] 1.726, 95% confidence interval [n CI] 1.400-2.128; n P<0.001), hypertension (n OR 3.744, 95% n CI 1.227-11.426; n P=0.020) and eosinophil count (n OR 0.287, 95% n CI 0.102-0.616; n P=0.043) were the independent influencing factors for the poor short-term outcome. ROC curve analysis showed that the area under the curve of eosinophil count for predicting the poor short-term outcome was 0.717 (95% n CI 0.642-0.792), the best cutoff value was 0.075×10n 9/L, and its sensitivity and specificity for predicting the poor short-term outcome were 88.6% and 51.4% respectively.n Conclusion:The decreased eosinophil count had a certain predictive value for the poor short-term clinical outcome of patients with acute ischemic stroke.