炎症与血栓标志物对脑梗死静脉溶栓患者预后转归的预测价值研究

Study on the Predictive Value of Inflammatory and Thrombotic Markers for Prognosis in Patients with Cerebral Infarction Treated with Intravenous Thrombolysis

摘要: 目的：探讨炎症标志物(NLR, PLR, CRP)与血栓相关标志物(TM, TAT, D-D)在预测脑梗死静脉溶栓患者90天功能转归中的临床价值。方法：回顾性分析2024年3月至12月本院198例接受静脉溶栓的急性脑梗死患者资料，根据90天后改良Rankin量表(mRS)评分分为转归良好组(mRS ≤ 2分，n = 153)和转归不良组(mRS > 2分，n = 45)。比较两组间炎症与血栓标志物水平差异，采用Logistic回归分析筛选独立预测因素。结果：转归不良组NLR、PLR、CRP、TM、TAT、D-D水平显著高于转归良好组(P < 0.05)。多因素Logistic回归显示，NLR、PLR、CRP、TM是转归不良的独立危险因素(P < 0.05)。结论：NLR、PLR、CRP和TM是脑梗死静脉溶栓预后评估的有效生物标志物，联合检测可提升预测准确性，为个体化治疗提供参考。

Abstract: Objective: To explore the clinical value of inflammatory markers (NLR, PLR, CRP) and thrombosis-related markers (TM, TAT, D-D) in predicting the 90-day functional outcome of patients with acute cerebral infarction treated with intravenous thrombolysis. Methods: A retrospective analysis was conducted on the data of 198 patients with acute cerebral infarction who received intravenous thrombolysis in our hospital from March to December 2024. The patients were divided into a good outcome group (mRS ≤ 2, n = 153) and a poor outcome group (mRS > 2, n = 45) based on the modified Rankin Scale (mRS) score at 90 days. The differences in the levels of inflammatory and thrombosis markers between the two groups were compared, and independent predictive factors were screened using logistic regression analysis. Results: The levels of NLR, PLR, CRP, TM, TAT, and D-D were significantly higher in the poor outcome group than in the good outcome group (P < 0.05). Multivariate logistic regression analysis showed that NLR, PLR, CRP, and TM were independent risk factors for poor outcome (P < 0.05). Conclusion: NLR, PLR, CRP, and TM are effective biomarkers for the prognosis assessment of intravenous thrombolysis in cerebral infarction. Combined detection can improve the accuracy of prediction and provide a reference for individualized treatment.