Ren Hao, Liu Xiao, Wang Lin, Gao Yanjun
Department of Neurology, The Affiliated Hospital of Chengde Medical University, Chengde, China.
Department of Neurology, The Affiliated Hospital of Chengde Medical University, Chengde, China.
J Stroke Cerebrovasc Dis. 2017 Nov;26(11):2595-2602. doi: 10.1016/j.jstrokecerebrovasdis.2017.06.019. Epub 2017 Aug 26.
Lymphocyte-to-monocyte ratio (LMR) is associated with diverse malignancies and cardiovascular diseases. However, it has not yet been identified whether LMR is correlated with stroke severity and prognosis. We aimed to explore the relationship between LMR and stroke severity, prognosis, and the predictive value of LMR on a 3-month functional outcome in patients with acute ischemic stroke (AIS).
A total of 512 patients were enrolled in this study. Baseline demographic and clinical data of all patients were collected. Based on the LMR value on admission (>4.83, 2.97-4.83, <2.97), patients were divided into 3 groups. Moderate to severe stroke was defined as a National Institutes of Health Stroke Scale score of 6 or higher. Poor outcome was defined as a modified Rankin Scale score of 3 or higher. We used the Spearman rank correlation to evaluate the relationship between LMR and stroke severity. Binary logistic regression analysis was used to assess risk factors of stroke severity and prognosis. The receiver operating characteristic (ROC) curve was used to estimate the predictive value of LMR on prognosis.
LMR was inversely correlated with stroke severity (r = -.014, P = .019). Moreover, LMR was an independent protective factor of stroke severity (odds ratio [OR] .891, 95% confidence interval [CI] .815-.973, P = .010) and prognosis (OR .507, 95% CI .437-.590, P < .001). ROC indicated that an LMR lower than 2.99 predicted a poor outcome, with a sensitivity of 69.3% and a specificity of 86.6%.
A lower LMR on admission was independently associated with severe stroke and 3-month poor outcome in patients with AIS.
淋巴细胞与单核细胞比值（LMR）与多种恶性肿瘤及心血管疾病相关。然而，LMR是否与卒中严重程度及预后相关尚未明确。我们旨在探讨LMR与急性缺血性卒中（AIS）患者的卒中严重程度、预后以及LMR对3个月功能结局的预测价值之间的关系。
本研究共纳入512例患者。收集所有患者的基线人口统计学和临床数据。根据入院时的LMR值（>4.83、2.97 - 4.83、<2.97），将患者分为3组。中度至重度卒中定义为美国国立卫生研究院卒中量表评分6分或更高。不良结局定义为改良Rankin量表评分3分或更高。我们采用Spearman等级相关性分析评估LMR与卒中严重程度之间的关系。采用二元逻辑回归分析评估卒中严重程度和预后的危险因素。采用受试者工作特征（ROC）曲线评估LMR对预后的预测价值。
LMR与卒中严重程度呈负相关（r = -0.014，P = 0.019）。此外，LMR是卒中严重程度（比值比[OR] 0.891，95%置信区间[CI] 0.815 - 0.973，P = 0.010）和预后（OR 0.507，95% CI 0.437 - 0.590，P < 0.001）的独立保护因素。ROC分析表明，LMR低于2.99预测不良结局，敏感性为69.3%，特异性为86.6%。
入院时较低的LMR与AIS患者的严重卒中和3个月不良结局独立相关。
