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| 动态对比增强磁共振成像联合PLR、NLR预测急性脑梗死短期预后的回顾性研究 |
| A retrospective study of dynamic contrast-enhanced magnetic resonance imaging combined with PLR and NLR in predicting short-term prognosis of acute cerebral infarction |
| 投稿时间：2021-05-20 修订日期：2021-05-20 |
| DOI： |
| 中文关键词: 急性脑梗死 短期预后 动态对比增强磁共振成像 PLR NLR 预测价值 |
| 英文关键词: Acute cerebral infarction Short-term prognosis Dynamic contrast-enhanced magnetic resonance imaging PLR NLR Predictive value |
| 基金项目:湖南省自然科学基金资助项目（20171768） |
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| 中文摘要: |
| 目的：探讨动态对比增强磁共振成像（DCE-MRI）联合血小板与淋巴细胞比值（PLR）、中性粒细胞与淋巴细胞比值（NLR）预测急性脑梗死短期预后的价值。方法：回顾性分析我院从2015年1月～2019年12月收治的80例急性脑梗死患者的临床资料。将所有患者根据改良Rankin量表（mRS）评分差异分作预后良好组（mRS评分≤2分）50例和预后不良组（mRS评分＞2分）30例。比较两组DCE-MRI相关参数[容量转移常数相对值（rKtrans）、速率常数相对值（rKep）、血管外细胞外间隙容积分数相对值（rVe）]、入院时PLR、NLR以及基线资料，采用多因素Logistic回归分析急性脑梗死患者短期预后不良的影响因素。此外，采用受试者工作特征（ROC）曲线分析DCE-MRI、PLR、NLR单独及联合预测急性脑梗死短期预后的效能。结果：预后良好组各项DCE-MRI参数均明显高于预后不良组（P＜0.05）。预后良好组PLR、NLR、年龄以及入院时美国国立卫生研究院脑卒中量表（NIHSS）评分均低于预后不良组（P＜0.05）。经多因素Logistic回归分析可得：PLR、NLR、年龄以及入院时NIHSS评分均是急性脑梗死患者短期预后不良的危险因素（OR＞1，P＜0.05）。DCE-MRI联合PLR、NLR预测急性脑梗死短期预后不良的曲线下面积、敏感度、特异度以及约登指数均高于上述单项预测。结论：DCE-MRI联合PLR、NLR预测急性脑梗死短期预后不良的效能较高，具有一定应用价值。 |
| 英文摘要: |
| Objective: To investigate the value of dynamic contrast-enhanced magnetic resonance imaging (DCE-MRI) combined with platelet-lymphocyte ratio (PLR) and neutrophil-lymphocyte ratio (NLR) in predicting short-term prognosis of acute cerebral infarction. Methods: The clinical data of 80 patients with acute cerebral infarction who were admitted to our hospital from January 2015 to December 2019 were retrospectively analyzed. According to the modified Rankin Scale (MRS) score differences, all the patients were divided into good prognosis group (mRS score ≤2 scores) with 50 cases and poor prognosis group (mRS score >2 scores) with 30 cases. DCE-MRI related parameters[relative value of capacity transfer constant(rKtrans), relative value of the rate constant(rKep), relative value of extracellular space volume fraction outside the blood vessel(rVe)], PLR, NLR and baseline data at admission were compared between the two groups, and Multivariate Logistic regression was used to analyze the influencing factors of poor short-term prognosis in patients with acute cerebral infarction. In addition, receiver operating characteristic(ROC) curve was used to analyze the efficacy of DCE-MRI combined with PLR and NLR in predicting short-term prognosis of acute cerebral infarction. Results: All DCE-MRI parameters in the good prognosis group were significantly higher than those in the poor prognosis group (P<0.05). PLR, NLR, age and National Institutes of Health Stroke Scale (NIHSS) score at admission in the good prognosis group were lower than those in the poor prognosis group (P<0.05). Multivariate logistic regression analysis showed that: PLR, NLR, age and NIHSS score at admission were independent risk factors for poor short-term prognosis of patients with acute cerebral infarction (OR>1, P<0.05). The area under the curve, sensitivity, specificity and Youden index of DCE-MRI combined with PLR and NLR in predicting poor short-term prognosis of acute cerebral infarction were higher than those of the above single prediction. Conclusion: DCE-MRI combined with PLR and NLR has a high value in predicting poor short-term prognosis of acute cerebral infarction, and has certain application value. |
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