Department of Neurology, St George's University Hospitals NHS Foundation Trust, London, SW17 0QT, UK.
Department of Neurology, Royal Cornwall Hospitals NHS Trust, Truro, TR1 3LQ, UK.
J Neuroinflammation. 2020 Feb 18;17(1):60. doi: 10.1186/s12974-020-01739-y.
Neutrophil-lymphocyte ratio (NLR) and lymphocyte-monocyte ratio (LMR) are associated with clinical outcomes in malignancy, cardiovascular disease and stroke. Here we investigate their association with outcome after acute ischaemic stroke treated by mechanical thrombectomy (MT).
Patients were selected using audit data for MT for acute anterior circulation ischaemic stroke at a UK centre from May 2016-July 2017. Clinical and laboratory data including neutrophil, lymphocyte and monocyte count tested before and 24 h after MT 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 and LMR with functional outcome.
One hundred twenty-one patients (mean age 66.4 ± 16.7, 52% female) were included. Higher NLR (adjusted OR 0.022, 95% CI, 0.009-0.34, p = 0.001) and lower LMR (adjusted OR - 0.093, 95% CI (- 0.175)-(- 0.012), p = 0.025) at 24-h post-MT were significantly associated with poorer functional outcome when controlling for age, baseline NIHSS score, infarct size, presence of good collateral supply, recanalisation and symptomatic intracranial haemorrhage on multivariate logistic regression. Admission NLR or LMR were not significant predictors of mRS at 3 months. The optimal cut-off values of NLR and LMR at 24-h post-MT that best discriminated poor outcome were 5.5 (80% sensitivity and 60% specificity) and 2.0 (80% sensitivity and 50% specificity), respectively on receiver operating characteristic curve analysis.
NLR and LMR tested at 24 h after ictus or intervention may predict 3-month functional outcome.
中性粒细胞-淋巴细胞比值（NLR）和淋巴细胞-单核细胞比值（LMR）与恶性肿瘤、心血管疾病和中风的临床结局相关。在此，我们研究了它们与接受机械血栓切除术（MT）治疗的急性缺血性中风患者结局的相关性。
本研究使用英国一家中心的 MT 治疗急性前循环缺血性中风的审核数据，选择了患者。收集了包括 MT 前后 24 小时内的中性粒细胞、淋巴细胞和单核细胞计数在内的临床和实验室数据。不良功能结局定义为 3 个月时改良 Rankin 量表（mRS）评分 3-6 分。采用多变量逻辑回归分析来探讨 NLR 和 LMR 与功能结局的关系。
共纳入 121 例患者（平均年龄 66.4±16.7 岁，52%为女性）。多变量逻辑回归分析表明，MT 后 24 小时 NLR 升高（调整后的比值比 0.022，95%CI 0.009-0.34，p=0.001）和 LMR 降低（调整后的比值比 -0.093，95%CI（-0.175）-（-0.012），p=0.025）与功能结局不良显著相关，控制年龄、基线 NIHSS 评分、梗死体积、良好的侧支循环供应、再通和症状性颅内出血后，结果仍具有统计学意义。入院时 NLR 或 LMR 不是 3 个月时 mRS 的显著预测因子。在接受 MT 治疗后 24 小时进行 NLR 和 LMR 检测，最佳截断值分别为 5.5（80%敏感性和 60%特异性）和 2.0（80%敏感性和 50%特异性），受试者工作特征曲线分析显示。
NLR 和 LMR 在中风或介入后 24 小时检测可能预测 3 个月的功能结局。
