中性粒细胞计数、中性粒细胞比值与小卒中和 TIA 中的新发卒中。
Neutrophil counts, neutrophil ratio, and new stroke in minor ischemic stroke or TIA.
机构信息
From the Department of Neurology (B.Z., Y.P., J.J., X.M., X.Z., L.L., H.L., Yilong Wang, Yongjun Wang), Beijing Tiantan Hospital, Capital Medical University; Taizhou First People's Hospital (B.Z., Z.W.), Zhejiang; China National Clinical Research Center for Neurological Diseases (B.Z., Y.P., J.J., X.M., X.Z., L.L., H.L., Yilong Wang, Yongjun Wang); Center of Stroke (B.Z., Y.P., J.J., X.M., X.Z., L.L., H.L., Yilong Wang, Yongjun Wang), Beijing Institute for Brain Disorders; Beijing Key Laboratory of Translational Medicine for Cerebrovascular Disease (B.Z., Y.P., J.J., X.M., X.Z., L.L., H.L., Yilong Wang, Yongjun Wang), China; INI Stroke Network (D.W.), OSF Healthcare System, University of Illinois College of Medicine, Peoria; and Dell Medical School (S.C.J.), University of Texas at Austin.
出版信息
Neurology. 2018 May 22;90(21):e1870-e1878. doi: 10.1212/WNL.0000000000005554. Epub 2018 Apr 20.
OBJECTIVE
Evidence about whether neutrophil counts or neutrophil ratio is associated with new stroke is scant. The aim of this study is to assess the association of neutrophil counts or neutrophil ratio with a new stroke in patients with minor stroke or TIA.
METHODS
We derived data from the Clopidogrel in High-Risk Patients With Acute Nondisabling Cerebrovascular Events trial. Patients with a minor stroke or TIA were categorized into 4 groups according to the quartile of neutrophil counts or neutrophil ratio. The primary outcome was a new stroke (ischemic or hemorrhagic), and secondary outcomes included a new composite vascular event (stroke, myocardial infarction, or death resulting from cardiovascular causes) and ischemic stroke during the 90-day follow-up. We assessed the association between neutrophil counts, neutrophil ratio, and risk of new stroke.
RESULTS
A total of 4,854 participants were enrolled, among whom 495 had new strokes at 90 days. Compared with the first quartile, the second, third, and fourth quartiles of neutrophil counts were associated with increased risk of new stroke (adjusted hazard ratio 1.40 [95% confidence interval (CI) 1.05-1.87], 1.55 [95% CI 1.17-2.05], and 1.69 [95% CI 1.28-2.23], respectively, for trend <0.001). Similar results were observed for the endpoint of composite events and ischemic stroke. Parallel results were found for neutrophil ratio.
CONCLUSION
High levels of both neutrophil counts and neutrophil ratio were associated with an increased risk of new stroke, composite events, and ischemic stroke in patients with a minor ischemic stroke or TIA.
目的
关于中性粒细胞计数或中性粒细胞比值与新发卒中的相关性的证据较少。本研究旨在评估中性粒细胞计数或中性粒细胞比值与小卒中或 TIA 患者新发卒中的相关性。
方法
我们从氯吡格雷在伴有急性非致残性脑血管事件的高危患者中的疗效（CHANCE）试验中提取数据。根据中性粒细胞计数或中性粒细胞比值的四分位数，将小卒中或 TIA 患者分为 4 组。主要结局是新发卒中（缺血性或出血性），次要结局包括新发复合血管事件（卒中、心肌梗死或心血管原因导致的死亡）和 90 天随访期间的缺血性卒中。我们评估了中性粒细胞计数、中性粒细胞比值与新发卒中风险之间的关系。
结果
共纳入 4854 名参与者，其中 495 名在 90 天内发生新发卒中。与第 1 四分位相比，第 2、3 和 4 四分位的中性粒细胞计数与新发卒中风险增加相关（校正后的危险比 1.40 [95%置信区间 1.05-1.87]、1.55 [95%置信区间 1.17-2.05] 和 1.69 [95%置信区间 1.28-2.23]，趋势检验 P<0.001）。复合事件和缺血性卒中终点也观察到了类似的结果。中性粒细胞比值也有类似的结果。
结论
在小缺血性卒中和 TIA 患者中，高水平的中性粒细胞计数和中性粒细胞比值均与新发卒中、复合事件和缺血性卒中风险增加相关。
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