Zheng Xiaowei, Zeng Nimei, Wang Aili, Zhu Zhengbao, Zhong Chongke, Xu Tan, Xu Tian, Peng Yanbo, Peng Hao, Li Qunwei, Ju Zhong, Geng Deqin, Zhang Yonghong, He Jiang
Department of Epidemiology, School of Public Health and Jiangsu Key Laboratory of Preventive and Translational Medicine for Geriatric Diseases, Medical College of Soochow University, Suzhou, China.
Department of Epidemiology, Tulane University School of Public Health and Tropical Medicine, New Orleans, LA, United States.
Curr Neurovasc Res. 2018;15(2):151-157. doi: 10.2174/1567202615666180626154857.
It is unclear whether white blood cell on admission has a prognosis value on ischemic stroke and whether its function is affected by other inflammation factors. We hypothesized that elevated white blood cell is associated with stroke severity and 3-month mortality after acute ischemic stroke.
A total of 3891 acute ischemic stroke subjects from the China Antihypertensive Trial in Acute Ischemic Stroke (CATIS) were included in this analysis. Participants were divided into four groups according to quartiles of white blood cell on admission (cutoff points for the quintiles: 5.60×10/L,6.83×10/L,8.50×10/L). The primary outcome was a combination of death and major disability (modified Rankin Scale score ≥3) at 3 months. Secondary outcomes were major disability, death, and vascular events, respectively.
After adjustment for major conventional risk factors, elevated white blood cell on admission was associated with poor primary and secondary outcomes after acute ischemic stroke. Compared with the lowest quartile, the ORs (95% CIs) for the highest quartile were 1.79 (1.37-2.91) and 1.62 (1.21-3.55) for primary outcome in model 1 and model 2. In addition, there was a linear association between white blood cell and primary outcome at 3-months (P for linear trend = 0.001).
This analysis indicated that elevated white blood cell on admission is associated with 3-months poor prognosis in ischemic stroke patients independently of other inflammation factors. The results emphasize the need for further research on the application of anti-inflammatory therapy.
入院时白细胞对缺血性卒中是否具有预后价值，以及其功能是否受其他炎症因子影响尚不清楚。我们推测急性缺血性卒中后白细胞升高与卒中严重程度及3个月死亡率相关。
本分析纳入了中国急性缺血性卒中降压试验（CATIS）中的3891例急性缺血性卒中患者。根据入院时白细胞四分位数将参与者分为四组（五分位数的分界点：5.60×10⁹/L、6.83×10⁹/L、8.50×10⁹/L）。主要结局为3个月时死亡和严重残疾的联合情况（改良Rankin量表评分≥3）。次要结局分别为严重残疾、死亡和血管事件。
在调整主要传统危险因素后，入院时白细胞升高与急性缺血性卒中后的主要和次要不良结局相关。与最低四分位数相比，最高四分位数在模型1和模型2中主要结局的OR（95%CI）分别为1.79（1.37 - 2.91）和1.62（1.21 - 3.55）。此外，白细胞与3个月时的主要结局之间存在线性关联（线性趋势P = 0.001）。
本分析表明，入院时白细胞升高与缺血性卒中患者3个月的不良预后相关，且独立于其他炎症因子。结果强调了对抗炎治疗应用进行进一步研究的必要性。
