王玉萍　　黄昌艳　　吴芳　　陈鸿恩

[摘要] 目的 研究超敏C反應蛋白（hs-CRP）及中性粒细胞/淋巴细胞比值（NLR）对缺血性脑卒中患者的预后预测。 方法 选取2018年1月至2019年12月在我院住院的100例脑卒中患者作为研究对象，依据预后的良好与不良分成两组，其中80例mRS≤2分作为对照组，将另外20例mRS>2分作为观察组，分别检测两组患者的hs-CRP水平及NLR比值，比较两组出院后1个月、2个月、3个月、6个月的神经功能缺损评分（NIHSS）、卒中复发风险评分（Essen）以及日常生活能力评分（Barthel指数）。 结果 观察组入院时及出院时的NLR比值明显高于对照组，差异有统计学意义（P<0.05）;两组入院时hs-CRP比较，差异无统计学意义（P>0.05），观察组出院时hs-CRP明显高于对照组，差异有统计学意义（P<0.05）;观察组出院后1个月、2个月、3个月、6个月的NIHSS评分及Essen评分均高于对照组，差异有统计学意义（P<0.05）;观察组出院后1个月、2个月、3个月、6个月的Barthel指数评分均低于对照组，差异有统计学意义（P<0.05）。 结论 对缺血性脑卒中患者的预后预测可通过入院时的超敏C反应蛋白、中性粒细胞及淋巴细胞的比值作为初步预测，同时结合患者的神经功能缺损程度及卒中复发风险评分进行预后判断。

[关键词] 超敏C反应蛋白;中性粒细胞;淋巴细胞;缺血性脑卒中;预后预测

[中图分类号] R743.3;R741.04          [文献标识码] B          [文章编号] 1673-9701（2021）11-0115-04

Research on the prognostic prediction of patients with ischemic stroke by high-sensitivity C-reactive protein and neutrophil/lymphocyte ratio

WANG Yuping   HUANG Changyan   WU Fang   CHEN Hong′en

Department of Clinical Laboratory， Ganzhou Municipal Hospital in Jiangxi Province， Ganzhou   341000， China

[Abstract] Objective To study the effect of hypersensitive C-reactive protein（hs-CRP） and neutrophil/lymphocyte ratio （NLR） in predicting the prognosis of patients with ischemic stroke. Methods A total of 100 cases of patients with stroke admitted to our hospital from January 2018 to December 2019 were selected as the research objects， and they were divided into the control group（n=80） and the observation group（n=20） according to the good and poor prognosis. In the control group， mRS ≤2 points， while in the observation group mRS > 2 points. The hs-CRP level and NLR ratio between the two groups were detected respectively， and the national institutes of health stroke scale（NIHSS）， stroke relapse risk score（Essen） and activity of daily living（Barthel index） between the two groups were compared within 1 month， 2 months， 3 months and 6 months after discharge. Results On admission and discharge， the NLR ratio in the observation group was higher than that in the control group， with significant difference（P<0.05）. There was no difference of hs-CRP between the two groups on admission（P>0.05）. After discharge， hs-CRP in the observation group was significant higher than that in the control group， with significant difference（P<0.05）. The NIHSS scores and Essen scores within 1 month， 2 months， 3 months and 6 months after discharge were higher than those in the control group， with significant difference （P<0.05）. The Barthel index scores in the observation group within 1 month， 2 months， 3 months and 6 months after discharge were lower than those in the control group， with significant difference（P<0.05）. Conclusion The hs-CRP and NLR at admission can be used to preliminarily predict the prognosis of patients with ischemic stroke， and the prognosis can be judged according to the NIHSS degree and the Essen score.

[Key words] High sensitivity C-reactive protein; Neutrophils; Lymphocytes; Ischemic stroke; Prognostic prediction

缺血性脑卒中俗称脑梗死，是由多种原因造成的脑血管受损及脑组织损害，占我国居民死亡原因第一位，严重威胁着我国居民的生命健康。临床研究表明，炎症反应可促进缺血性脑卒中的发生，且患者发生卒中后，血管缺血-再灌注可导致大量炎症因子的释放，从而加重了对脑组织的损伤[1]。超敏C反应蛋白（hs-CRP）可检测心脑血管疾病发生时的炎症反应，还可参与动脉粥样硬化的发生和发展，促进血栓形成，不利于患者预后[2]。中性粒细胞与淋巴细胞比值（NLR）这两种指标失衡是造成炎症反应发生的基础，当中性粒细胞上调、淋巴细胞计数下降，则NLR比值增高，表明炎症反应较大，因此，NLR可作为反映全身系统性炎症反应的指标之一[3]。本研……