Hu Jia, Zhou Wei, Zhou Zhiming, Han Jian, Dong Wanli
Department of Neurology, The First Affiliated Hospital, Yijishan Hospital of Wannan Medical College, Wuhu, Anhui 241001, P.R. China.
Department of Neurology, The First Affiliated Hospital of Medical College of Soochow University, Suzhou, Jiangsu 215123, P.R. China.
Exp Ther Med. 2020 Apr;19(4):2497-2504. doi: 10.3892/etm.2020.8514. Epub 2020 Feb 11.
Post-stroke depression (PSD) is the most prevalent psychiatric complication of acute ischemic stroke. The neutrophil-to-lymphocyte ratio (NLR) and the platelet-to-lymphocyte ratio (PLR) are indicators of inflammation and are associated with stroke and depression. Therefore, the purpose of the present study was to examine the relationship between NLR/PLR and PSD. Retrospective analysis was carried out in 376 patients with first-ever acute ischemic stroke in the First Affiliated Yijishan Hospital of Wannan Medical College between March 2015 and September 2017. Patients were divided into PSD (n=104; 27.7%) and non-PSD (n=272; 72.3%) groups according to the Diagnostic and Statistical Manual of Mental Disorders-IV criteria at 6 months after stroke. Clinical data were collected retrospectively. NLR and PLR were acquired retrospectively from the routine blood tests performed at admission. A total of 120 healthy volunteers from the physical examination center in the First Affiliated Yijishan Hospital of Wannan Medical College were recruited as controls. Using logistic regression analysis, NLR (≥4.02) and PLR (≥203.74) were independently associated with PSD. NLR, odds ratio (OR) 3.926, 95% confidence intervals (CI, 2.365-7.947), P<0.001; PLR, OR 3.853, 95% CI (2.214-6.632), P=0.002. The ability of the combined index [area under the receiver operating characteristic curve, 0.701; 95% CI (0.622-0.780); P<0.001] to diagnose PSD was greater than that of either ratio alone. Higher NLRs and PLRs (≥4 quartile) were associated with PSD with a 5.79-fold (P<0.001) increase compared with lower levels of both. Higher NLRs and PLRs were found to be associated with depression 6 months after stroke, and the combined index was more meaningful than either alone in the early clinical detection of PSD.
卒中后抑郁（PSD）是急性缺血性卒中最常见的精神并发症。中性粒细胞与淋巴细胞比值（NLR）和血小板与淋巴细胞比值（PLR）是炎症指标，与卒中和抑郁相关。因此，本研究旨在探讨NLR/PLR与PSD之间的关系。对2015年3月至2017年9月期间在皖南医学院弋矶山医院首次发生急性缺血性卒中的376例患者进行回顾性分析。根据卒中后6个月时的《精神障碍诊断与统计手册》第四版标准，将患者分为PSD组（n = 104；27.7%）和非PSD组（n = 272；72.3%）。回顾性收集临床资料。NLR和PLR从入院时进行的常规血液检查中回顾性获取。皖南医学院弋矶山医院体检中心的120名健康志愿者被招募为对照组。采用逻辑回归分析，NLR（≥4.02）和PLR（≥203.74）与PSD独立相关。NLR，比值比（OR）3.926，95%置信区间（CI，2.365 - 7.947），P < 0.001；PLR，OR 3.853，95% CI（2.214 - 6.632），P = 0.002。联合指标[受试者操作特征曲线下面积，0.701；95% CI（0.622 - 0.780）；P < 0.001]诊断PSD的能力大于单独的任何一个比值。较高的NLR和PLR（≥第4四分位数）与PSD相关，与两者较低水平相比增加了5.79倍（P < 0.001）。发现较高的NLR和PLR与卒中后6个月的抑郁相关，并且联合指标在PSD的早期临床检测中比单独的任何一个更有意义。
