Department of Neurosurgery and Neurology, Nicolaus Copernicus University in Toruń, Ludwik Rydygier Collegium Medicum, 85-168 Bydgoszcz, Poland.
Department of Pathophysiology, Nicolaus Copernicus University in Toruń, Ludwik Rydygier Collegium Medicum, 85-094 Bydgoszcz, Poland.
Medicina (Kaunas). 2019 Jul 5;55(7):342. doi: 10.3390/medicina55070342.
Ischaemic stroke (IS) is the leading cause of death and disability worldwide. All stages of cerebral ischaemia, but especially acute phase, are associated with inflammatory response. Recent studies showed that neutrophil-to-lymphocyte ratio (NLR) and lymphocyte-to-monocyte ratio (LMR) may be used to assess inflammation in IS. To test whether there is a relationship between these parameters and type of stroke treatment, we analysed NLR and LMR in IS patients treated with three different modalities. The study included 58 adults with acute IS. A total of 28 patients received intravenous thrombolysis. In another 10 patients, the thrombolytic therapy was followed by thrombectomy and 20 patients did not undergo causal treatment. Blood samples were obtained within 24 h of the stroke diagnosis to calculate NLR and LMR. Next, NLR and LMR of the study subgroups were compared. Our study revealed that NLR was significantly higher in patients treated with thrombectomy following thrombolysis, compared to no causal treatment. Statistical analysis demonstrated that patients with high National Institutes of Health Stroke Scale (NIHSS) scores presented higher NLR than in those with low NIHSS scores. Additionally, patients with high-sensitivity C-reactive protein (hs-CRP) ≥ 3 mg/L presented with significantly higher NLR and significantly lower LMR than the group of patients with lower hs-CRP (<3 mg/L). The main finding of this pilot study was that NLR in IS patients treated using thrombectomy following thrombolysis was markedly higher than that in other treatment groups, which was associated with increased severity of the disease in these patients. Therefore, patients with higher NLR may be expected to have more severe stroke. The link between stroke severity and NLR deserves further study.
缺血性脑卒中（IS）是全球范围内导致死亡和残疾的主要原因。脑缺血的所有阶段，尤其是急性期，都与炎症反应有关。最近的研究表明，中性粒细胞与淋巴细胞比值（NLR）和淋巴细胞与单核细胞比值（LMR）可用于评估 IS 中的炎症。为了检验这些参数与 IS 治疗类型之间是否存在关系，我们分析了采用三种不同方法治疗的 IS 患者的 NLR 和 LMR。该研究纳入了 58 名急性 IS 成年患者。共 28 名患者接受了静脉溶栓治疗。在另外 10 名患者中，溶栓治疗后进行了血栓切除术，20 名患者未进行病因治疗。在脑卒中诊断后 24 小时内采集血样，计算 NLR 和 LMR。然后，比较了研究亚组的 NLR 和 LMR。我们的研究表明，与未进行病因治疗的患者相比，接受溶栓后血栓切除术治疗的患者的 NLR 显著升高。统计分析表明，NIHSS 评分较高的患者的 NLR 高于 NIHSS 评分较低的患者。此外，hs-CRP≥3mg/L 的患者的 NLR 显著高于 hs-CRP<3mg/L 的患者，LMR 显著低于 hs-CRP<3mg/L 的患者。这项初步研究的主要发现是，接受溶栓后血栓切除术治疗的 IS 患者的 NLR 明显高于其他治疗组，这与这些患者疾病严重程度增加有关。因此，NLR 较高的患者可能会出现更严重的脑卒中。脑卒中严重程度与 NLR 之间的联系值得进一步研究。
