中性粒细胞与淋巴细胞比值可预测急性缺血性卒中血管内治疗后的功能及安全性结局。
Neutrophil-Lymphocyte Ratio Predicts Functional and Safety Outcomes after Endovascular Treatment for Acute Ischemic Stroke.
作者信息
Duan Zhenhui, Wang Huaiming, Wang Zhen, Hao Yonggang, Zi Wenjie, Yang Dong, Zhou Zhiming, Liu Wenhua, Lin Min, Shi Zhonghua, Lv Penghua, Wan Yue, Xu Gelin, Xiong Yunyun, Zhu Wusheng, Liu Xinfeng
机构信息
Department of Neurology, Jinling Hospital, Southern Medical University, Nanjing, China.
Department of Neurology, Jinling Hospital, Medical School of Nanjing University, Nanjing, China.
出版信息
Cerebrovasc Dis. 2018;45(5-6):221-227. doi: 10.1159/000489401. Epub 2018 May 15.
BACKGROUND AND OBJECTIVE
Endovascular treatment (EVT) is proven to be safe and effective for treating acute large vessel occlusion stroke (LVOS). The neutrophil-lymphocyte ratio (NLR) reflects systemic inflammation, which plays an important role in the process of treating ischemic stroke. This study aims to explore the relationship between NLR and the clinical outcomes of LVOS patients undergoing EVT.
METHODS
Patients were selected from the EVT for acUte Anterior circuLation (ACTUAL) ischemic stroke registry. The laboratory data (neutrophil count, lymphocyte count) before EVT were collected. Poor functional outcome was defined as modified Rankin Scale (mRS) of 3-6 at 3 months. Multivariable logistic regression analyses were performed to explore the relationship of NLR with functional outcome, symptomatic intracranial hemorrhage (sICH), and mortality.
RESULTS
We eventually included 616 patients (median of age, 66 years; 40.3% female). There were 350 (56.7%) patients achieving mRS of 3-6 at 3 months, 98 (15.9%) patients with sICH, and the mortality at 3 months was 24.8% (153/616). Baseline NLR was independently associated with poor functional outcome (OR 1.58; 95% CI 1.02-2.45; p = 0.039) and sICH (OR 1.84; 95% CI 1.09-3.11; p = 0.023) but showed a trend for predicting 3-month mortality (OR 1.57; 95% CI 0.94-2.65; p = 0.088).
CONCLUSIONS
NLR independently predicts 3-month functional outcome and sICH but the existence of a trend association with mortality after EVT for acute anterior circulation LVOS patients.
背景与目的
血管内治疗（EVT）已被证明对治疗急性大血管闭塞性卒中（LVOS）安全有效。中性粒细胞与淋巴细胞比值（NLR）反映全身炎症，在缺血性卒中治疗过程中起重要作用。本研究旨在探讨NLR与接受EVT的LVOS患者临床结局之间的关系。
方法
从急性前循环（ACTUAL）缺血性卒中登记研究的血管内治疗患者中选取病例。收集血管内治疗前的实验室数据（中性粒细胞计数、淋巴细胞计数）。功能预后不良定义为3个月时改良Rankin量表（mRS）评分为3 - 6分。进行多变量逻辑回归分析，以探讨NLR与功能预后、症状性颅内出血（sICH）和死亡率之间的关系。
结果
我们最终纳入了616例患者（年龄中位数为66岁；女性占40.3%）。350例（56.7%）患者在3个月时mRS评分为3 - 6分，98例（15.9%）患者发生sICH，3个月时死亡率为24.8%（153/616）。基线NLR与功能预后不良（比值比[OR] 1.58；95%置信区间[CI] 1.02 - 2.45；p = 0.039）和sICH（OR 1.84；95% CI 1.09 - 3.11；p = 0.023）独立相关，但在预测3个月死亡率方面呈趋势性（OR 1.57；95% CI 0.94 - 2.65；p = 0.088）。
结论
NLR可独立预测急性前循环LVOS患者血管内治疗后3个月的功能预后和sICH，但与死亡率存在趋势性关联。
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