[1]贾建普,王丽轩,赵泽宇,等.颅内动脉粥样硬化性狭窄患者血清ox-LDL，RC和NLR联合检测对临床预后的预测价值[J].现代检验医学杂志,2025,40(02):104-108.[doi:10.3969/j.issn.1671-7414.2025.02.019]
　JIA Jianpu,WANG Lixuan,ZHAO Zeyu,et al.Prognostic Value of Combined Serum ox-LDL, RC and NLR Tests for Clinical Prognosis in Patients with Intracranial Atherosclerotic Stenosis[J].Journal of Modern Laboratory Medicine,2025,40(02):104-108.[doi:10.3969/j.issn.1671-7414.2025.02.019]
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颅内动脉粥样硬化性狭窄患者血清ox-LDL，RC和NLR联合检测对临床预后的预测价值()
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《现代检验医学杂志》[ISSN:/CN:]

卷:
第40卷
期数:
2025年02期
页码:
104-108
栏目:
论著
出版日期:
2025-03-15

文章信息/Info

Title:
Prognostic Value of Combined Serum ox-LDL, RC and NLR Tests for Clinical Prognosis in Patients with Intracranial Atherosclerotic Stenosis
文章编号:
1671-7414（2023）02-104-05
作者:
贾建普; 王丽轩; 赵泽宇; 张丽冉; 张乐国; 夏瑞雪
（沧州市中心医院神经内科，河北沧州 061000）
Author(s):
JIA Jianpu; WANG Lixuan; ZHAO Zeyu; ZHANG Liran; ZHANG Leguo; XIA Ruixue
（Department of Neurology, Cangzhou Central Hospital，Hebei Cangzhou 061000，China）
关键词:
颅内动脉粥样硬化性狭窄; 氧化型低密度脂蛋白; 血清残余胆固醇; 中性粒细胞与淋巴细胞比率
分类号:
R743.1；R446.11
DOI:
10.3969/j.issn.1671-7414.2025.02.019
文献标志码:
A
摘要:
目的 探讨颅内动脉粥样硬化性狭窄（ICAS）患者血清氧化型低密度脂蛋白（ox-LDL）、残余胆固醇（RC）和中性粒细胞与淋巴细胞比率（NLR）联合检测对临床预后的预测价值。方法 选取2022 年6 月～ 2023 年12 月沧州市中心医院收治的急性脑梗死（ACI）患者，并经头部MRI 及临床诊断为ICAS（观察组，n=160），根据改良Rankin量表（mRS）评分，分为预后良好组（mRS 评分0 ～ 2 分，n=52）和预后不良组（mRS 评分≥ 3 分，n=108）；另选取同期体检健康的志愿者160 例作为对照组。磁性微粒免疫层析法检测血清ox-LDL 水平；收集患者临床资料，计算RC，NLR 水平；Spearman 法分析血清ox-LDL，RC，NLR 水平与mRS 评分的相关性；Logistic 回归分析ICAS 患者预后的影响因素；受试者工作特征（ROC）曲线分析血清ox-LDL，RC，NLR 水平对ICAS 患者预后的预测价值。结果 与对照组相比，观察组患者血清ox-LDL（53.65±8.35 U/L vs 33.23±6.42 U/L），RC（0.82±0.15 mmol/L vs 0.52±0.13mmol/L），NLR 水平（2.84±0.38 vs 1.95±0.26）均显著升高，差异具有统计学意义（t=24.523，65.079，62.911，均P＜ 0.05）；预后不良组血清ox-LDL（57.52±8.72 U/L），RC（0.84±0.14 mmol/L），NLR 水平（3.02±0.45）] 均高于预后良好组（45.62±6.63 U/L，0.79±0.12 mmol/L，2.48±0.36），差异具有统计学意义（t=8.699，8.507，7.562，均P ＜ 0.05）；且两组患者血清TC，LDL-C，HDL-C 水平及mRS 评分比较，差异具有统计学意义（t=15.755 ～ 27.072，均P ＜ 0.05）。血清ox-LDL，RC，NLR 水平与mRS 评分均呈正相关（r=0.612，0.623，0.653，均P ＜ 0.05）。血清TC，LDL-C，HDL-C，ox-LDL，RC，NLR 水平均为影响ICAS 预后的因素（均P ＜ 0.05）；血清ox-LDL，RC，NLR预测ICAS 患者预后的AUC（95%CI）分别为0.894（0.835 ～ 0.937），0.860（0.797 ～ 0.910），0.817（0.748 ～ 0.874），三者联合预测的AUC（95%CI）为0.965（0.923 ～ 0.987），三者联合预测相比于血清ox-LDL，RC，NLR 单独预测更具有价值（Z=3.030，3.969，4.839，均P ＜ 0.05）。结论 ICAS 患者血清ox-LDL，RC，NLR 水平均上升，与mRs 评分呈正相关，三者对ICAS 患者预后均有预测价值，且三者联合检测的临床价值更高。
Abstract:
Objective To explore the prognostic value of combined serum oxidized low-density lipoprotein (ox-LDL), remnant cholesterol (RC) and neutrophil-to-lymphocyte ratio (NLR) tests for clinical prognosis in patients with intracranial atherosclerotic stenosis (ICAS). Methods Patients with acute cerebral infarction were admitted to Cangzhou Central Hospital from June 2022 to December 2023 and diagnosed with ICAS by head MRI. A clinical diagnosis was selected (observation group, n=160). According to the modified Rankin scale (mRS) score, they were separated into a good prognosis group (mRS 0 ～ 2 points，n=52) and a poor prognosis group (mRS ≥ 3 points，n=108). 160 healthy volunteers who underwent physical examinations were used as a reference group. Magnetic particle immunochromatography was applied to detect serum ox-LDL levels. Clinical data of patients were collected, and the levels of RC and NLR were calculated. The Spearman method was used to analyze the correlation between serum ox-LDL, RC, NLR levels and mRS scores. Logistic regression was applied to analyze the factors influencing prognosis in ICAS patients. Receiver operating characteristic curve (ROC) was used to analyze the predictive value of serum ox-LDL, RC and NLR levels for the prognosis of ICAS patients. Results Compared with reference group, the serum levels of ox-LDL (53.65±8.35 U/L vs 33.23±6.42 U/L), RC (0.82±0.15 mmol/L vs 0.52±0.13 mmol/L) and NLR (2.84±0.38 vs 1.95±0.26) in observation group were obviously increased，and the differences were statistically significant (t=24.523, 65.079, 62.911, all P<0.05).The serum levels of ox-LDL (57.52±8.72 U/L),RC (0.84±0.14 mmol/L) and NLR (3.02±0.45) in the poor prognosis group were higher than those in the good prognosis group （45.62±6.63 U/L，0.79±0.12 mmol/L，2.48±0.36），and the differences were statistically significant（t=8.699，8.507，7.562， all P ＜ 0.05）, and there were differences in TC, LDL-C, HDL-C levels and mRS scores between the two groups，and the differences were statistically significant (t=15.755 ～ 27.072，all P<0.05). The serum levels of ox-LDL, RC, NLR were positively correlated with mRS scores (r=0.612, 0.623, 0.653, all P<0.05). The levels of TC，LDL-C，HDL-C，ox-LDL，RC and NLR were all factors that affected the prognosis of ICAS (all P<0.05). The AUC of serum ox-LDL, RC and NLR for predicting prognosis in ICAS patients were 0.894（0.835 ～ 0.937），0.860（0.797 ～ 0.910）and 0.817（0.748 ～ 0.874）, respectively. The combined AUC（95%CI）of the three was 0.965（0.923 ～ 0.987）, the combination of the three was more valuable than predicting serum ox-LDL, RC and NLR alone (Z=3.030，3.969，4.839, all P<0.05). Conclusion The serum levels of ox-LDL, RC and NLR in ICAS patients have all increased and are positively correlated with mRs scores. The three have predictive value for the prognosis of ICAS patients, and the combined detection of the three has higher clinical value.

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备注/Memo

备注/Memo:
基金项目：沧州市重点研发计划指导项目（编号：222106088）。
作者简介：贾建普（1981-），男，硕士，副主任医师，研究方向：脑血管病，E-mail：jiajianpu3170@163.com。
更新日期/Last Update: 2025-03-15