入院白细胞水平与急性缺血性脑卒中患者出院结局的关系

摘要

目的：探讨缺血性脑卒中患者入院时不同白细胞水平与出院结局的关系。方法连续性纳入内蒙古兴安盟人民医院2009年6月1日～2012年5月31日的全部缺血性脑卒中患者为研究对象，共计3440例，分析入院时白细胞水平与急性缺血性脑卒中患者出院结局的关系。结果研究对象中发生不良结局的共有359人，占10．44％。单因素Logistic回归分析显示，年龄、体温、高血压、高血糖、脑卒中病史和吸烟、饮酒是发生结局不良的危险因素（均P＜0．01），高三酰甘油是发生结局不良的保护因素（P＜0．01）。与白细胞计数最低分位组相比，第3、4分位组结局不良明显增多（ OR＝1．78，95％CI：1．23～2．58；OR＝3．98，95％CI：2．85～5．56；均P＜0．001）。在调整了年龄，体温，高血压，高血糖，脑卒中病史，高甘油三酯，吸烟和饮酒后，与白细胞计数最低分位组相比，第3、4分位组结局不良明显增多（ OR＝1．77，95％CI：1．20～2．61；OR＝3．76，95％CI：2．63～5．37；均P＜0．001）。结论急性缺血性脑卒中患者入院时较高的白细胞水平可能是出院结局不良的独立危险因素。%Objective To discuss the association between different white blood cell levels of patients at admission and discharged outcome of acute ischemic stroke patients .Methods The patients with acute ischemic stroke in Xing'anmeng People's Hospital from June 1, 2009 to May 31, 2012 were collected, adding up to 3 440 consecutive cases , analyzed the relationship between white blood cell levels at admission and discharge outcome in patients with acute ischemic stroke .Results A total of 359 people occurred poor outcomes in the study , accounting for 10.44%.Univariate Logistic regression analysis showed that age , body temperature,hypertension, high blood sugar,history of stroke and smoking, drinking were the risk factors of adverse outcomes ( all P<0.01), high triglyceride was the protective factors of adverse outcome ( P<0.01) .Compared with the lowest quartile group of white blood cell count, the third and fourth quartile groups had significantly more poor outcomes (OR=1.78,95%CI:1.23-2.58;OR =3.98,95%CI:2.85 -5.56;all P<0.001).After adjusting age, body temperature, blood pressure, high blood sugar, history of stroke, high triglycerides, smoking and drinking,compared with the lowest quartile group of white blood cell count , the third and fourth quartile groups had significantly more poor outcomes (OR=1.77,95%CI:1.20-2.61;OR=3.76,95%CI:2.63-5.37;all P<0.001).Conclusion Higher levels of white blood cell may be the independent risk factor for poor discharged outcome in patients with acute ischemic stroke.