Cumhuriyet University Neurology Department, Sivas, Turkey.
Sivas Numune State Hospital Cardiology Department, Sivas, Turkey.
Neurol Neurochir Pol. 2018 Mar;52(2):150-155. doi: 10.1016/j.pjnns.2017.08.011. Epub 2017 Aug 24.
The inflammatory process is a very important stage in the development and prognosis of acute ischemic stroke (AIS). The monocyte to high-density lipoprotein (HDL) ratio (MHR) is accepted as a novel marker for demonstrating inflammation. However, the role of MHR as a predictor of mortality in patients with AIS remains unclear.
We retrospectively enrolled 466 patients who were referred to our clinic within the first 24hours of symptom presentation and who were diagnosed with AIS between January 2008 and June 2016. Four hundred and eight controls of similar age and gender were also included. The patient group was classified into two groups according to 30-day mortality. The groups were compared in terms of monocyte counts, HDL, and MHR values.
The patient group had significantly higher monocyte counts and lower HDL levels; therefore, this group had higher values of MHR compared to controls. Additionally, the monocyte count and MHR value were higher, and the HDL level was lower in non-surviving patients (p<0.001). The MHR value was also observed as a significant independent variable of 30-day mortality in patients with AIS (p<0.001). The optimum cut-off value of MHR in predicting the 30-day mortality for patients with AIS was 17.52 (95% CI 0.95-0.98).
Our study demonstrated that a high MHR value is an independent predictor of 30-day mortality in patients with AIS.
炎症过程是急性缺血性脑卒中（AIS）发展和预后的一个非常重要的阶段。单核细胞与高密度脂蛋白（HDL）比值（MHR）被认为是一种新的炎症标志物。然而，MHR 作为 AIS 患者死亡率的预测因子的作用尚不清楚。
我们回顾性纳入了 466 名在症状出现后 24 小时内就诊并于 2008 年 1 月至 2016 年 6 月期间被诊断为 AIS 的患者。还纳入了 408 名年龄和性别相匹配的对照组。根据 30 天死亡率，将患者组分为两组。比较两组的单核细胞计数、HDL 和 MHR 值。
患者组的单核细胞计数显著升高，HDL 水平降低；因此，与对照组相比，该组的 MHR 值更高。此外，非存活患者的单核细胞计数和 MHR 值更高，HDL 水平更低（p<0.001）。MHR 值也是 AIS 患者 30 天死亡率的显著独立预测变量（p<0.001）。MHR 预测 AIS 患者 30 天死亡率的最佳截断值为 17.52（95%CI 0.95-0.98）。
我们的研究表明，高 MHR 值是 AIS 患者 30 天死亡率的独立预测因子。
