Department of Neurology, West China Hospital, Sichuan University, Chengdu, Sichuan, China.
Curr Neurovasc Res. 2020;17(4):429-436. doi: 10.2174/1567202617666200517110509.
Malignant brain edema (MBE) is a life-threatening complication for patients with large hemispheric infarction (LHI). Stroke-related inflammatory responses may cause secondary brain injury and lead to brain edema. The neutrophil to lymphocyte ratio (NLR) is a well-known systemic inflammatory biomarker. The aim of this study was to evaluate if NLR is associated with MBE in patients with LHI.
A retrospective analysis was performed of LHI patients within 24 h from stroke onset admitted to the Department of Neurology, West China Hospital from January 1, 2017 to December 31, 2018. Blood samples were collected upon admission. MBE was diagnosed by any neurological deterioration accompanied by brain edema in follow-up images. Patients were categorized according to NLR tertiles. Univariate analyses were performed to identify potential confounding variables and a multivariate logistic regression analysis was conducted to determine the correlation between NLR and MBE.
A total of 257 patients with a mean age of 68.6 ± 14.0 years were identified. Among them, 83 (32.3%) patients developed MBE with a median time of one day (interquartile range [IQR] 0-2 days) from hospital admission. An elevated NLR was related to an increased risk of MBE when the lowest and highest tertiles were compared (odds ratio 2.27, 95% confidence interval 1.11-4.62, p = 0.024). The risk of MBE increased with the increase of NLR in a dosedependent manner (p for trend = 0.029). No interaction between potential modifiers and NLR on MBE was observed.
Higher NLR was associated with an increased risk of MBE in patients with LHI.
恶性脑肿胀（MBE）是大面积半球性梗死（LHI）患者的一种危及生命的并发症。与中风相关的炎症反应可能导致继发性脑损伤并导致脑水肿。中性粒细胞与淋巴细胞比值（NLR）是一种众所周知的全身性炎症生物标志物。本研究旨在评估 NLR 是否与 LHI 患者的 MBE 相关。
回顾性分析了 2017 年 1 月 1 日至 2018 年 12 月 31 日期间在华西医院神经内科发病 24 小时内的 LHI 患者。入院时采集血样。MBE 通过随访图像中任何神经功能恶化伴脑水肿来诊断。根据 NLR 三分位数将患者进行分类。进行单变量分析以确定潜在的混杂变量，并进行多变量逻辑回归分析以确定 NLR 与 MBE 之间的相关性。
共纳入 257 名平均年龄为 68.6±14.0 岁的患者。其中，83 名（32.3%）患者发生 MBE，从入院到发病的中位数时间为 1 天（四分位距 [IQR] 0-2 天）。与最低和最高三分位数相比，NLR 升高与 MBE 的风险增加相关（比值比 2.27，95%置信区间 1.11-4.62，p=0.024）。随着 NLR 的增加，MBE 的风险呈剂量依赖性增加（趋势检验 p=0.029）。在 MBE 中未观察到潜在修饰因子与 NLR 之间的相互作用。
较高的 NLR 与 LHI 患者 MBE 的风险增加相关。
