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缺血性中风后数小时外周循环白细胞亚型水平的时间趋势

Temporal Trends in the Levels of Peripherally Circulating Leukocyte Subtypes in the Hours after Ischemic Stroke.

作者信息

Gill Dipender, Sivakumaran Prasanthi, Aravind Adarsh, Tank Atisha, Dosh Roshni, Veltkamp Roland

机构信息

Imperial College London, Postgraduate Centre, Hammersmith Hospital; Imperial College Healthcare NHS Trust, Charing Cross Hospital.

Imperial College Healthcare NHS Trust, Charing Cross Hospital.

出版信息

J Stroke Cerebrovasc Dis. 2018 Jan;27(1):198-202. doi: 10.1016/j.jstrokecerebrovasdis.2017.08.023. Epub 2017 Sep 15.

Abstract

BACKGROUND

Leukocyte-mediated neuroinflammation may affect outcomes after ischemic stroke.

AIMS

To explore temporal changes in levels of peripherally circulating leukocyte subtypes in the early hours after ischemic stroke in humans.

METHODS

Retrospective analysis of a single-center database of consecutive thrombolysis cases for acute ischemic stroke (AIS). Multivariable regression analysis was used to explore temporal changes in the levels of peripherally circulating leukocyte subtypes in the hours immediately after ischemic stroke. A natural logarithm transformation was used to achieve normally distributed residuals, and adjustment was made for the severity of stroke, blood glucose concentration, sex, and age.

RESULTS

Blood samples were taken a median time of approximately 2 hours after stroke symptom onset. Median peripheral neutrophil and lymphocyte counts on admission were 4.8 × 10cells per liter (interquartile range [IQR], 3.6-7.2 × 10 cells per liter) and 1.9 × 10cells per liter (IQR, 1.3-2.6 × 10cells per liter), respectively. Multivariable regression analysis revealed that after adjustment there was a linear increase in the natural logarithm of the peripheral neutrophil count (P < .01), with a linear decrease in the natural logarithm of the peripheral lymphocyte count (P < .01) in the hours immediately after stroke onset. No significant temporal associations were found between the levels of the other peripherally circulating leukocyte subtypes.

CONCLUSIONS

Immediately after ischemic stroke, there is an exponential increase in the neutrophil count and an exponential decrease in the lymphocyte count.

摘要

背景

白细胞介导的神经炎症可能影响缺血性中风后的预后。

目的

探讨人类缺血性中风后早期外周循环白细胞亚型水平的时间变化。

方法

对急性缺血性中风(AIS)连续溶栓病例的单中心数据库进行回顾性分析。采用多变量回归分析探讨缺血性中风后数小时内外周循环白细胞亚型水平的时间变化。使用自然对数变换以实现残差呈正态分布,并对中风严重程度、血糖浓度、性别和年龄进行校正。

结果

在中风症状发作后中位时间约2小时采集血样。入院时外周中性粒细胞和淋巴细胞计数中位数分别为每升4.8×10⁹个细胞(四分位间距[IQR],3.6 - 7.2×10⁹个细胞/升)和每升1.9×10⁹个细胞(IQR,1.3 - 2.6×10⁹个细胞/升)。多变量回归分析显示,校正后中风发作后数小时内外周中性粒细胞计数的自然对数呈线性增加(P < 0.01),外周淋巴细胞计数的自然对数呈线性下降(P < 0.01)。未发现其他外周循环白细胞亚型水平之间存在显著的时间关联。

结论

缺血性中风后立即出现中性粒细胞计数呈指数增加,淋巴细胞计数呈指数下降。

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