中国神经再生研究(英文版)

中国神经再生研究(英文版) ›› 2019, Vol. 14 ›› Issue (10): 1772-1779.doi: 10.4103/1673-5374.258411

• 原著:脑损伤修复保护与再生 • 上一篇    下一篇

嗜酸性粒细胞减少可作为急性缺血性卒中严重程度的潜在预测因子

  

  • 出版日期:2019-10-15 发布日期:2019-10-15

Eosinopenia is a predictive factor for the severity of acute ischemic stroke

Hui-Min Zhao 1, Wen-Qian Qin 1, Pei-Ji Wang 2, Zhong-Min Wen 1   

  1. 1 Department of Neurology, the Second Affiliated Hospital of Soochow University, Suzhou, Jiangsu Province, China
    2 Department of Orthopedics, the Second Affiliated Hospital of Soochow University, Suzhou, Jiangsu Province, China
  • Online:2019-10-15 Published:2019-10-15
  • Contact: Zhong-Min Wen, PhD, wenzhongminsz@126.com

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摘要：

既往研究表明，在急性缺血性脑卒中患者中，嗜酸性粒细减少与患者死亡相关，而嗜酸性粒细胞与急性缺血性脑卒中患者梗死体积、感染率和不良预后间的关系并不清楚。为此，试验连续纳入了2017年1月至2018年2月在苏州大学附属第二医院住院治疗的首次急性缺血性卒中患者421例，男性273例(64.8%)，女性148例(35.2%)，平均年龄68.0±13.0岁，收集并记录所有患者的实验室检查结果，影像学结果及出院后90 d改良Rankin 量表分值(mRS)资料，试验通过四分位法将421患者按外周血嗜酸性粒细胞不同百分比分(< 0.4%，0.4-1.1%，1.1-2.3%，>2.3%)为4组。(1)通过Spearman相关分析发现，嗜酸性粒细胞百分比与大体积梗死呈负相关(rs=-0.514，P < 0.001)；(2) ROC曲线检测显示，嗜酸性粒细胞比中性粒细胞更准确识别大梗死体积(梗死直径大于3 cm，累及2条以上大动脉主要供血区)患者(ROC曲线下面积分别为0.906和0.876)；(3) Logistic回归分析显示，嗜酸性粒细百分比可作为急性缺血性脑卒中的独立危险因素(P =0.002)，调整潜在的混杂因素后，嗜酸性粒细胞百分比减少与高感染率(肺部及尿路感染)，大梗死体积，不良预后结局(mRS评分>3分)有关(P-trend < 0.001)；(4)结果证实，在急性缺血性脑卒患者中嗜酸性粒细胞百分比减少与高感染率，大梗死体积，不良预后有关。嗜酸性粒细减少可作为急性缺血性脑卒严重性的潜在预测因子。该试验已经苏州大学附属第二医院医学伦理委员会批准(批准号：K10，批准时间：2015-11-10)。

orcid:0000-0002-8804-5726 (Zhong-Min Wen)

关键词: 嗜酸性粒细减少, 嗜酸性粒细胞, 缺血, 卒中, 梗死体积, 感染, 临床预后, 中性粒细胞增多, 危险因素, 预测因子, 神经再生

Abstract:

Previous data have revealed an association between eosinopenia and mortality of acute ischemic stroke. However, the relationship of eosinopenia with infarct volume, infection rate, and poor outcome of acute ischemic stroke is still unknown. The retrospective study included 421 patients (273 males, 65%; mean age, 68.0 ± 13.0 years) with first acute ischemic stroke who were hospitalized in the Second Affiliated Hospital of Soochow University, China, from January 2017 to February 2018. Laboratory data, neuroimaging results, and modified Rankin Scale scores were collected. Patients were divided into four groups according to their eosinophil percentage level (< 0.4%, 0.4–1.1%, 1.1–2.3%, ≥ 2.3%). Spearman’s correlation analysis showed that the percentage of eosinophils was negatively correlated with infarct volume (rs = −0. 514, P < 0.001). Receiver operating characteristic analysis demonstrated that eosinopenia predicted a large infarct volume more accurately than neutrophilia; the area under curve was 0.906 and 0.876, respectively; a large infarct was considered as that with a diameter larger than 3 cm and involving more than two major arterial blood supply areas. Logistic regression analysis revealed that eosinophil percentage was an independent risk factor for acute ischemic stroke (P = 0.002). Moreover, eosinophil percentage was significantly associated with large infarct volume, high infection rate (pulmonary and urinary tract infections), and poor outcome (modified Rankin Scale score > 3) after adjusting for potential confounding factors (P-trend < 0.001). These findings suggest that eosinopenia has the potential to predict the severity of acute ischemic stroke. This study was approved by the Ethics Committee of the Second Affiliated Hospital of Soochow University, China (approval number: K10) on November 10, 2015.

Key words: nerve regeneration, eosinopenia, eosinophil, ischemia, stroke, infarct volume, infection, clinical outcome, neutrophilia, risk factors, predictive factor, neural regeneration