Department of Neurosurgery, St. Vincent's Hospital, College of Medicine, The Catholic University of Korea, Seoul, South Korea.
Curr Neurovasc Res. 2020;17(5):676-685. doi: 10.2174/1567202617999201117120905.
Prognostic significance of inflammatory response has been reported in various diseases. The objective of this study was to analyze the association between inflammation- based scores and the prognosis of patients who underwent neuro-intervention for aneurysmal subarachnoid hemorrhage (SAH).
Inflammation-based scores such as neutrophil to lymphocyte ratio (NLR), lymphocyte to monocyte ratio (LMR), and monocyte to high-density lipoprotein cholesterol (HDL-C) ratio (MHR) were analyzed for aneurysmal SAH patients who underwent endovascular intervention. Unfavorable functional outcome was defined as a modified Rankin Scale (mRS) score of 3-6. Receiver operating characteristic (ROC) curve analysis was performed to identify cut-off values of inflammation- based scores for predicting unfavorable functional outcome. Logistic regression analyses were performed to explore the relationship between inflammation-based scores and the prognosis of patients.
A total of 498 patients were enrolled. Optimal cutoff values of inflammation-based scores of NLR, LMR, and MHR for unfavorable functional outcome were 5.7, 4.2, and 1.5, respectively (p < 0.001, < 0.001, and 0.004, respectively). In multivariate analysis, NLR value ≥ 5.7 (odds ratio [OR] 1.92, 95% CI 1.42-3.42; P = 0.008), LMR value < 4.2 (OR 1.74, 95% CI 1.48-2.98; P = 0.018), and MHR value ≥ 1.5 (OR 1.44, 95% CI 1.22-2.82; P = 0.040) were independently associated with unfavorable functional outcome.
Inflammation based scores were associated with functional outcome after endovascular intervention for aneurysmal SAH. Higher NLR and MHR with lower LMR could predict unfavorable outcomes of aneurysmal SAH patients who underwent endovascular intervention.
炎症反应的预后意义在各种疾病中已有报道。本研究旨在分析炎症指标与接受神经介入治疗的动脉瘤性蛛网膜下腔出血（SAH）患者预后的相关性。
分析了接受血管内介入治疗的动脉瘤性 SAH 患者的炎症指标，如中性粒细胞与淋巴细胞比值（NLR）、淋巴细胞与单核细胞比值（LMR）和单核细胞与高密度脂蛋白胆固醇比值（MHR）。不良功能结局定义为改良 Rankin 量表（mRS）评分 3-6 分。进行受试者工作特征（ROC）曲线分析，以确定炎症指标预测不良功能结局的截断值。采用 logistic 回归分析探讨炎症指标与患者预后的关系。
共纳入 498 例患者。NLR、LMR 和 MHR 预测不良功能结局的最佳截断值分别为 5.7、4.2 和 1.5（p<0.001、<0.001 和 0.004）。多因素分析显示，NLR 值≥5.7（比值比 [OR] 1.92，95%可信区间 [CI] 1.42-3.42；P=0.008）、LMR 值<4.2（OR 1.74，95%CI 1.48-2.98；P=0.018）和 MHR 值≥1.5（OR 1.44，95%CI 1.22-2.82；P=0.040）与不良功能结局独立相关。
炎症指标与动脉瘤性 SAH 患者血管内介入治疗后的功能结局相关。较高的 NLR 和 MHR 及较低的 LMR 可能预测接受血管内介入治疗的动脉瘤性 SAH 患者的不良结局。
