Department of Neurology, Seoul National University College of Medicine, Seoul, Korea.
Department of Neurology, Seoul National University Hospital, Seoul, Korea.
PLoS One. 2019 Aug 26;14(8):e0221597. doi: 10.1371/journal.pone.0221597. eCollection 2019.
Inflammation plays an important role in atherosclerosis and its complications. Since a dysregulated inflammatory response is associated with early neurological deterioration (END), serum neutrophil-to-lymphocyte ratio (NLR) could be a marker of END as well.
In this study, we evaluated the relationship between the serum NLR and END in patients with ischemic stroke due to large-artery atherosclerosis (LAA).
We evaluated consecutive patients with ischemic stroke due to LAA between January 2010 and December 2015. END was defined as an increase ≥ 2 on the total NIHSS score or ≥ 1 on the motor NIHSS score within the first 72 hours of admission. The NLR was calculated by dividing the absolute neutrophil count by the absolute lymphocyte count.
Of the 349 included patients, 18.1% (n = 63) had END events. In multivariate analysis, serum NLR was independently associated with END (adjusted odds ratio, 1.08; 95% confidence interval [1.00-1.16], P = 0.043). Time to admission, and in-situ thrombosis and artery-to-artery embolization mechanisms were also significantly associated with END events. In an analysis of the relationship between serum NLR and vascular lesion burden, serum NLR was positively correlated with both the degree of stenotic lesions (P for trend = 0.006) and the number of vessel stenosis (P for trend = 0.038) in a dose-response manner. We also compared serum NLR by the stroke mechanisms: patients with hypoperfusion or in-situ thrombosis had the highest levels of NLR: however, only those with in-situ thrombosis had significantly higher NLR in the END group compared to the non-END group (P = 0.005).
Serum NLR levels were associated with END events in patients with ischemic stroke due to LAA. Since NLR was also closely correlated with the underlying vascular lesions, our results indicated clues for mechanisms of END events.
炎症在动脉粥样硬化及其并发症中起着重要作用。由于炎症反应失调与早期神经功能恶化（END）有关，因此血清中性粒细胞与淋巴细胞比值（NLR）也可能是 END 的标志物。
本研究旨在评估大动脉粥样硬化（LAA）性缺血性卒中患者血清 NLR 与 END 之间的关系。
我们评估了 2010 年 1 月至 2015 年 12 月期间连续因 LAA 导致缺血性卒中的患者。END 定义为入院后 72 小时内总 NIHSS 评分增加≥2 或运动 NIHSS 评分增加≥1。NLR 通过将绝对中性粒细胞计数除以绝对淋巴细胞计数来计算。
在 349 例纳入患者中，有 18.1%（n=63）发生 END 事件。多变量分析显示，血清 NLR 与 END 独立相关（调整优势比，1.08；95%置信区间[1.00-1.16]，P=0.043）。入院时间以及原位血栓形成和动脉到动脉栓塞机制也与 END 事件显著相关。在分析血清 NLR 与血管病变负担之间的关系时，血清 NLR 与狭窄病变程度呈正相关（趋势 P 值=0.006），与血管狭窄数量呈正相关（趋势 P 值=0.038）。我们还比较了根据卒中机制的血清 NLR：低灌注或原位血栓形成患者的 NLR 水平最高：然而，只有原位血栓形成患者的 END 组的 NLR 明显高于非 END 组（P=0.005）。
LAA 性缺血性卒中患者血清 NLR 水平与 END 事件相关。由于 NLR 与潜在血管病变密切相关，因此我们的结果为 END 事件的机制提供了线索。
