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头颈动脉夹层的炎症标志物与预后:一项来自三级医院卒中中心的研究

The inflammatory markers and prognosis of cervicocephalic artery dissection: a stroke center study from a tertiary hospital.

作者信息

Senadim Songul, Çoban Eda, Tekin Betül, Balcik Zeynep Ezgi, Köksal Ayhan, Soysal Aysun, Ataklı Dilek

机构信息

Department of Neurology, University of Health Sciences, Bakirkoy Prof. Dr. Mazhar Osman Training and Research Hospital for Psychiatric, Neurologic and Neurosurgical Diseases, Zuhuratbaba Mah. Dr. Tevfik Sağlam Cad. No: 25/2, Bakirkoy, 34147, Istanbul, Turkey.

Karabuk University Education and Research Hospital, Karabuk, Turkey.

出版信息

Neurol Sci. 2020 Dec;41(12):3741-3745. doi: 10.1007/s10072-020-04699-6. Epub 2020 Sep 2.

Abstract

OBJECTIVE

Cervicocephalic artery dissection (CeAD) is the most common cause of ischemic stroke in young adults. Although the exact cause is unknown, inflammation is thought to have a role. Here, we investigated the relationship between CeAD and inflammation.

METHODS

Patients diagnosed with CeAD in our stroke center were evaluated retrospectively, and their demographic and clinical features were recorded. The C-reactive protein (CRP), erythrocyte sedimentation rate (ESR), white blood cell, neutrophil and lymphocyte counts, platelet/lymphocyte ratio (PLR), and neutrophil/lymphocyte ratio (NLR) were recorded on admission. Modified Rankin scores (mRS) were noted on admission and at 6 months to evaluate the dependency status and functional outcome of each patient.

RESULTS

Of the 95 patients in the study, 70 (73.7%) were male, and the mean age was 44.4 ± 9.8 years. Patients with high WBC count, ESR, PLR, and NLR frequently had mRS scores of 3-6 at admission; these differences were significant (p = 0.04, p = 0.02, p = 0.04, and p = 0.02, respectively). At 6 months, patients with high CRP and ESR at admission also had significantly poorer prognoses (p < 0.001, p = 0.002, respectively). PLR and NLR values were higher in patients with mRS of 3-6. But there were no significant differences between the good and poor prognosis groups regarding PLR and NLR (p = 0.22, p = 0.05, respectively).

CONCLUSION

Inflammation may have a role in the prognosis of CeAD, and inflammatory markers can be evaluated as auxiliary tests for determining prognosis.

摘要

目的

头颈动脉夹层(CeAD)是年轻成年人缺血性卒中最常见的病因。尽管确切病因尚不清楚,但炎症被认为起了一定作用。在此,我们研究了CeAD与炎症之间的关系。

方法

对在我们卒中中心诊断为CeAD的患者进行回顾性评估,并记录其人口统计学和临床特征。入院时记录C反应蛋白(CRP)、红细胞沉降率(ESR)、白细胞、中性粒细胞和淋巴细胞计数、血小板/淋巴细胞比值(PLR)以及中性粒细胞/淋巴细胞比值(NLR)。记录入院时及6个月时的改良Rankin评分(mRS),以评估每位患者的依赖状态和功能结局。

结果

该研究中的95例患者中,70例(73.7%)为男性,平均年龄为44.4±9.8岁。白细胞计数、ESR、PLR和NLR较高的患者入院时mRS评分常为3 - 6分;这些差异具有统计学意义(分别为p = 0.04、p = 0.02、p = 0.04和p = 0.02)。在6个月时,入院时CRP和ESR较高的患者预后也明显较差(分别为p < 0.001、p = 0.002)。mRS评分为3 - 6分的患者PLR和NLR值较高。但预后良好组与预后不良组在PLR和NLR方面无显著差异(分别为p = 0.22、p = 0.05)。

结论

炎症可能在CeAD的预后中起作用,炎症标志物可作为判断预后的辅助检查进行评估。

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