Department of Neurology, Xuanwu Hospital of Capital Medical University, Beijing, China.
Institute of Cerebrovascular Diseases Research, Xuanwu Hospital of Capital Medical University, Beijing, China.
Cell Transplant. 2021 Jan-Dec;30:9636897211004089. doi: 10.1177/09636897211004089.
Massive cerebral infarction (MCI) is a life-threatening disease and may lead to cerebral herniation. Neutrophil degranulation contributes to ischemic injury in the early stage. To investigate whether neutrophil degranulating factors can predict cerebral herniation and the long-term prognosis of patients with MCI and to investigate the relationship between neutrophil degranulation and blood brain barrier (BBB) damage. In this case-control study of 14 MCI patients, we divided the patients into a cerebral hernia group and no cerebral hernia group according to whether they developed cerebral herniation within 5 days. The prognosis of MCI patients was assessed using the Modified Rankin Scale (mRS) score at 6 months, which was the primary end point. The composition of white blood cells (WBC) and degranulating factors for neutrophils in the plasma of MCI patients was determined on days 2 and 4. Baseline characteristics were comparable in both groups. The neurological functional scores and long-term prognosis showed no difference between patients with or without cerebral herniation, while the mortality rate of the cerebral hernia group in the short term was higher ( < 0.05). The WBC count, neutrophil to lymphocyte ratio (NLR) and plasma myeloperoxidase (MPO) levels of patients with cerebral hernia were significantly higher than those of patients without cerebral hernia (all < 0.05). MPO is a better predictor of cerebral herniation, and the NLR showed superior predictive value in the prognosis of MCI patients. neutrophil degranulation may play an important role in malignant cerebral hernia during MCI. These data suggest that, MPO and the NLR might be predictive factors for cerebral herniation and the prognosis of MCI patients.
大面积脑梗死（MCI）是一种危及生命的疾病，可能导致脑疝。中性粒细胞脱颗粒作用导致早期缺血性损伤。探讨中性粒细胞脱颗粒因子是否能预测 MCI 患者的脑疝及长期预后，以及中性粒细胞脱颗粒与血脑屏障（BBB）损伤的关系。本病例对照研究纳入 14 例 MCI 患者，根据患者是否在 5 天内发生脑疝，将患者分为脑疝组和无脑疝组。采用改良 Rankin 量表（mRS）评分评估 MCI 患者 6 个月的预后，该评分是主要终点。分别于第 2 天和第 4 天测定 MCI 患者血浆中白细胞（WBC）和中性粒细胞脱颗粒因子的组成。两组患者的基线特征具有可比性。脑疝组和无脑疝组患者的神经功能评分和长期预后无差异，而脑疝组患者的短期死亡率较高（<0.05）。脑疝组患者的 WBC 计数、中性粒细胞与淋巴细胞比值（NLR）和血浆髓过氧化物酶（MPO）水平明显高于无脑疝组（均<0.05）。MPO 是脑疝的更好预测因子，NLR 在 MCI 患者预后中的预测价值更高。中性粒细胞脱颗粒可能在 MCI 期间恶性脑疝中起重要作用。这些数据表明，MPO 和 NLR 可能是脑疝和 MCI 患者预后的预测因子。
