中性粒细胞与淋巴细胞比值与急性缺血性脑卒中患者的早期临床结局。
Neutrophil to lymphocyte ratio and early clinical outcomes in patients with acute ischemic stroke.
机构信息
Department of Neurology, Korea University College of Medicine, Seoul, Republic of Korea; The George Institute for Global Health, Royal Prince Alfred Hospital and University of Sydney, Sydney, Australia; Department of Neurology, Royal North Shore Hospital, St Leonards and University of Sydney, Sydney, Australia.
The George Institute for Global Health, Royal Prince Alfred Hospital and University of Sydney, Sydney, Australia.
出版信息
J Neurol Sci. 2018 Apr 15;387:115-118. doi: 10.1016/j.jns.2018.02.002. Epub 2018 Feb 2.
BACKGROUND
The neutrophil to lymphocyte ratio (NLR) is closely linked to mortality in patients with cardiovascular disease. We investigated whether NLR is associated with early clinical outcomes in patients with acute ischemic stroke.
METHODS
We collated data from a tertiary hospital's stroke registry including admitted patients with a first-ever acute ischemic stroke within 72 h of onset. White blood cell counts and peripheral differential counts were measured on admission. Early clinical outcomes were in-hospital mortality and disability at discharge assessed by the modified Rankin scale (mRS).
RESULTS
Among 1131 stroke patients, 454 patients were included and classified into tertile groups based on NLR on admission. Patients in higher tertiles of NLR were likely to have severe neurologic deficit at discharge. Higher NLR tertiles were associated with an unfavourable shift of mRS score (p < .0001). This association remained significant after adjustment for clinical and laboratory variables including age, sex, hypertension, hypercholesterolemia, atrial fibrillation, stroke severity, and glucose level (p = .032 for trend). However, risk of death or major disability (score of 3-6 on mRS) and in-hospital mortality were not significantly different across NLR tertile groups.
CONCLUSIONS
In patients with acute ischemic stroke, NLR was predictive of short-term functional outcome.
背景
中性粒细胞与淋巴细胞比值（NLR）与心血管疾病患者的死亡率密切相关。我们研究了 NLR 是否与急性缺血性脑卒中患者的早期临床结局相关。
方法
我们整理了一家三级医院的卒中登记处的数据，包括发病 72 小时内首次发生急性缺血性卒中的住院患者。入院时测量白细胞计数和外周血分类计数。早期临床结局为住院期间的死亡率和出院时的残疾程度（采用改良 Rankin 量表（mRS）评估）。
结果
在 1131 例卒中患者中，纳入了 454 例患者，并根据入院时的 NLR 分为三分位组。NLR 较高的患者在出院时更可能有严重的神经功能缺损。较高的 NLR 三分位组与 mRS 评分的不利变化相关（p<0.0001）。在校正了年龄、性别、高血压、高胆固醇血症、心房颤动、卒中严重程度和血糖水平等临床和实验室变量后，这种关联仍然显著（趋势检验 p=0.032）。然而，NLR 三分位组之间的死亡或主要残疾（mRS 评分 3-6）风险和住院死亡率没有显著差异。
结论
在急性缺血性脑卒中患者中，NLR 可预测短期功能结局。
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