Hyun Sangho, Kwon Seungwon, Cho SeungYeon, Park SeongUk, Jung WooSang, Moon SangKwan, Park JungMi, Ko ChangNam, Cho KiHo
Department of Cardiology and Neurology, College of Korean Medicine, Kyung Hee University, Seoul, Republic of Korea.
Department of Cardiology and Neurology, College of Korean Medicine, Kyung Hee University, Seoul, Republic of Korea.
J Stroke Cerebrovasc Dis. 2015 Nov;24(11):2646-51. doi: 10.1016/j.jstrokecerebrovasdis.2015.07.024. Epub 2015 Aug 24.
Carotid stenosis is a risk factor in ischemic stroke. Although C-reactive protein, interleukin-6, and tumor necrosis factor-alpha are known to predict carotid atherosclerosis, they are difficult to obtain in clinical practice. By studying the association between neutrophil-to-lymphocyte ratio (NLR) and carotid artery intima-media thickening (IMT) in patients with ischemic stroke, we determined that the NLR can predict carotid stenosis.
We selected 252 patients with acute to subacute ischemic stroke who underwent carotid ultrasonography and complete and differential blood cell count tests. We collected data on sex, age, body mass index (BMI), alcohol consumption, smoking, hypertension, diabetes mellitus, dyslipidemia, and heart disease. Male and female patients were analyzed separately. We divided the subjects into 2 groups according to carotid IMT, and compared baseline characteristics and NLR between the 2 groups. The regression analysis was adjusted for confounding factors such as age, BMI, NLR, smoking, alcohol consumption, and a medical history of hypertension, diabetes mellitus, dyslipidemia, or heart disease.
Carotid IMT tended to significantly increase with NLR and age in men and with age in women. In men, multiple linear regression analyses adjusted for confounding factors showed that NLR (P < 0.001) and age (P = 0.001) had a significant positive association with carotid IMT (adjusted R(2) = 0.185, root mean squared error [MSE] = 0.152). However, no parameters showed significant positive associations in women.
NLR can be a clinically significant predictor of the degree of carotid stenosis in male patients with ischemic stroke. However, additional studies are required to obtain more concrete results.
颈动脉狭窄是缺血性卒中的一个危险因素。虽然已知C反应蛋白、白细胞介素-6和肿瘤坏死因子-α可预测颈动脉粥样硬化，但在临床实践中难以获取这些指标。通过研究缺血性卒中患者中性粒细胞与淋巴细胞比值（NLR）与颈动脉内膜中层增厚（IMT）之间的关联，我们确定NLR可预测颈动脉狭窄。
我们选取了252例急性至亚急性缺血性卒中患者，这些患者均接受了颈动脉超声检查以及全血细胞计数和分类检测。我们收集了患者的性别、年龄、体重指数（BMI）、饮酒情况、吸烟情况、高血压、糖尿病、血脂异常和心脏病等数据。男性和女性患者分别进行分析。我们根据颈动脉IMT将受试者分为两组，并比较两组的基线特征和NLR。回归分析对年龄、BMI、NLR、吸烟、饮酒以及高血压、糖尿病、血脂异常或心脏病病史等混杂因素进行了校正。
男性患者中，颈动脉IMT随NLR和年龄显著增加，女性患者中则仅随年龄增加。在男性患者中，经混杂因素校正后的多元线性回归分析显示，NLR（P < 0.001）和年龄（P = 0.001）与颈动脉IMT呈显著正相关（校正R² = 0.185，均方根误差[MSE] = 0.152）。然而，在女性患者中没有参数显示出显著的正相关。
NLR可能是缺血性卒中男性患者颈动脉狭窄程度的一个具有临床意义的预测指标。然而，需要更多研究以获得更确切的结果。
