Department of Neurology, The First Affiliated Hospital of Wenzhou Medical University, Wenzhou, China.
Department of Neurology, The Third Affiliated Hospital of Wenzhou Medical University, Wenzhou, China.
Brain Behav. 2020 Sep;10(9):e01741. doi: 10.1002/brb3.1741. Epub 2020 Jul 22.
Increased neutrophil-to-lymphocyte ratio (NLR) and hyperglycemia on admission are associated with poor outcomes in acute ischemic stroke (AIS) patients. We sought to evaluate the combined effect of increased NLR and hyperglycemia on the prognosis of ischemia stroke treated with intravenous thrombolysis (IVT).
Patients with acute ischemic stroke receiving IVT treatment were prospectively enrolled. All participants were followed for 3 months. According to the levels of NLR and blood glucose, patients were categorized into four groups: high NLR or nonhigh NLR with or without hyperglycemia. The associations between NLR values with or without hyperglycemia and outcomes of stroke after thrombolysis were assessed by multivariable logistic regression analysis.
Among the 381 stroke patients (median age 68 years, 61.68% man) included, 155 (40.68%) had a poor outcome (modified Rankin Scale score 3-6) during 3 months. After multivariate adjustment, high NLR with hyperglycemia increased the risk of 3-month poor outcome (OR = 4.42; 95% CI, 2.13-9.16), early neurological deterioration (END) (OR = 4.81; 95% CI, 2.08-11.12), and 3-month mortality (OR = 6.56; 95% CI, 1.92-22.40). A significant multiplicative interaction of NLR and blood glucose on 3-month poor outcome in ischemic stroke patients after thrombolysis was observed.
Ischemic stroke patients with concurrent high NLR and hyperglycemia increased risks of END, 3-month poor outcome, and mortality after thrombolysis.
入院时中性粒细胞与淋巴细胞比值（NLR）升高和高血糖与急性缺血性脑卒中（AIS）患者的不良预后相关。我们旨在评估入院时 NLR 升高和高血糖对接受静脉溶栓（IVT）治疗的缺血性脑卒中患者预后的联合影响。
前瞻性纳入接受 IVT 治疗的急性缺血性脑卒中患者。所有患者均随访 3 个月。根据 NLR 和血糖水平，患者分为四组：高 NLR 或非高 NLR 伴或不伴高血糖。多变量逻辑回归分析评估 NLR 值伴或不伴高血糖与溶栓后卒中结局的关系。
在纳入的 381 例脑卒中患者（中位年龄 68 岁，61.68%为男性）中，155 例（40.68%）在 3 个月时预后不良（改良 Rankin 量表评分 3-6）。多变量调整后，高 NLR 伴高血糖增加了 3 个月预后不良（OR=4.42；95%CI，2.13-9.16）、早期神经功能恶化（END）（OR=4.81；95%CI，2.08-11.12）和 3 个月死亡率（OR=6.56；95%CI，1.92-22.40）的风险。溶栓后缺血性脑卒中患者 NLR 和血糖对 3 个月预后不良的交互作用具有统计学意义。
同时存在高 NLR 和高血糖的缺血性脑卒中患者，END、3 个月预后不良和溶栓后死亡率的风险增加。
