Department of Neurology, The First People's Hospital of Jingzhou, The First Affiliated Hospital of Yangtze University, Jingzhou, 434000, China.
Acta Neurol Belg. 2021 Dec;121(6):1415-1421. doi: 10.1007/s13760-020-01289-3. Epub 2020 Feb 8.
Intravenous injection of alteplase is recommended for patients with minor disabling and not non-disabling ischemic stroke symptoms within 4.5 h of ischemic stroke symptom onset. However, it is hard for clinicians to distinguish which type of minor ischemic stroke is disabled at an early stage. In this study, we aimed to demonstrate early neutrophil-to-lymphocyte ratio is a prognostic marker in acute minor stroke or transient ischemic attack. 196 patients diagnosed with acute minor stroke or transient ischemic attack within 24 h of symptom onset were enrolled. Patients were divided into three groups according to the neutrophil-to-lymphocyte ratio value (< 2, 2-3, > 3). Clinical, neuroradiological, laboratory and follow-up data were collected from electronic database. Functional outcome was assessed by modified Rankin Scale. Neutrophil-to-lymphocyte ratio associated with functional outcome of 90 days was evaluated by logistic regression analysis, and we used receiver operating characteristic curve analysis to detect the overall predictive accuracy of this marker. Early neutrophil-to-lymphocyte ratio was associated with an increased risk of short-term functional outcome (OR 4.502, 95% CI 1.533-13.046, P = 0.006). The optimal cutoff value of neutrophil-to-lymphocyte ratio for prediction of short-term unfavorable outcome was 2.94 with a sensitivity of 69.6% and a specificity of 77.1% (area under the curve: 0.767, 95% CI 0.691-0.843). Early neutrophil-to-lymphocyte ratio is associated with short-term unfavorable functional outcome in patients with acute minor stroke or transient ischemic attack. Early neutrophil-to-lymphocyte ratio is beneficial for clinicians to distinguish minor disabling ischemic stroke at an early stage.
静脉注射阿替普酶适用于缺血性卒中和症状发作后 4.5 小时内出现轻微致残和非致残缺血性卒中症状的患者。然而，临床医生很难在早期区分哪种类型的轻微缺血性卒中是致残的。本研究旨在证明早期中性粒细胞与淋巴细胞比值是急性小卒中和短暂性脑缺血发作的预后标志物。196 名在症状发作后 24 小时内被诊断为急性小卒中和短暂性脑缺血发作的患者被纳入研究。根据中性粒细胞与淋巴细胞比值（<2、2-3、>3），将患者分为三组。从电子数据库中收集临床、神经影像学、实验室和随访数据。采用改良 Rankin 量表评估功能结局。通过逻辑回归分析评估中性粒细胞与淋巴细胞比值与 90 天功能结局的相关性，我们采用受试者工作特征曲线分析来检测该标志物的整体预测准确性。早期中性粒细胞与淋巴细胞比值与短期功能结局风险增加相关（OR 4.502，95%CI 1.533-13.046，P=0.006）。预测短期不良结局的中性粒细胞与淋巴细胞比值最佳截断值为 2.94，其敏感性为 69.6%，特异性为 77.1%（曲线下面积：0.767，95%CI 0.691-0.843）。早期中性粒细胞与淋巴细胞比值与急性小卒中和短暂性脑缺血发作患者的短期不良功能结局相关。早期中性粒细胞与淋巴细胞比值有助于临床医生在早期区分轻微致残性缺血性卒中。
