Department of Encephalopathy, Suzhou Hospital of Integrated Traditional Chinese and Western Medicine, Suzhou, 215101, China.
Department of Neurology and Suzhou Clinical Research Center of Neurological Disease, The Second Affiliated Hospital of Soochow University, No. 1055, Sanxiang Road, Suzhou, 215004, Jiangsu, China.
BMC Neurosci. 2021 Feb 5;22(1):8. doi: 10.1186/s12868-021-00610-x.
It has been shown that eosinophils are decreased and monocytes are elevated in patients with acute ischemic stroke (AIS), but the impact of eosinophil-to-monocyte ratio (EMR) on clinical outcomes among AIS patients remains unclear. We aimed to determine the relationship between EMR on admission and 3-month poor functional outcome in AIS patients.
A total of 521 consecutive patients admitted to our hospital within 24 h after onset of AIS were prospectively enrolled and categorized in terms of quartiles of EMR on admission between August 2016 and September 2018. The endpoint was the poor outcome defined as modified Rankin Scale score of 3 to 6 at month 3 after admission.
As EMR decreased, the risk of poor outcome increased (p < 0.001). Logistic regression analysis revealed that EMR was independently associated with poor outcome after adjusting potential confounders (odds ratio, 0.09; 95% CI 0.03-0.34; p = 0.0003), which is consistent with the result of EMR (quartile) as a categorical variable (odds ratio, 0.23; 95% CI 0.10-0.52; p < 0.0001). A non-linear relationship was detected between EMR and poor outcome, whose point was 0.28. Subgroup analyses further confirmed these associations. The addition of EMR to conventional risk factors improved the predictive power for poor outcome (net reclassification improvement: 2.61%, p = 0.382; integrated discrimination improvement: 2.41%, p < 0.001).
EMR on admission was independently correlated with poor outcome in AIS patients, suggesting that EMR may be a potential prognostic biomarker for AIS.
已有研究表明，急性缺血性脑卒中（AIS）患者的嗜酸性粒细胞减少，单核细胞升高，但嗜酸性粒细胞与单核细胞比值（EMR）与 AIS 患者临床结局的关系尚不清楚。本研究旨在确定入院时 EMR 与 AIS 患者 3 个月不良功能结局的关系。
2016 年 8 月至 2018 年 9 月，连续前瞻性纳入 521 例 AIS 发病 24 小时内入院的患者，并根据入院时 EMR 的四分位值进行分组。终点为 3 个月时改良 Rankin 量表评分 3-6 分的不良结局。
随着 EMR 的降低，不良结局的风险增加（p<0.001）。调整潜在混杂因素后，logistic 回归分析显示 EMR 与不良结局独立相关（比值比，0.09；95%置信区间，0.03-0.34；p=0.0003），与 EMR（四分位）作为分类变量的结果一致（比值比，0.23；95%置信区间，0.10-0.52；p<0.0001）。EMR 与不良结局之间存在非线性关系，拐点为 0.28。亚组分析进一步证实了这些相关性。将 EMR 加入常规危险因素可提高不良结局的预测能力（净重新分类改善：2.61%，p=0.382；综合判别改善：2.41%，p<0.001）。
入院时 EMR 与 AIS 患者的不良结局独立相关，提示 EMR 可能是 AIS 的潜在预后生物标志物。
