Department of Biomedicine - Unit of Anatomy and Department of Surgery and Physiology.
Department of Surgery and Physiology, Faculdade de Medicina da Universidade do Porto; Department of Clinical Pathology, Centro Hospitalar Universitário de São João, Porto, Portugal.
Port J Card Thorac Vasc Surg. 2021 Apr 8;28(1):45-51.
Inflammation is a common underlying feature of atherosclerosis. Several inflammatory biomarkers have been reported to have prognostic value, in several areas, including in vascular surgery. The neutrophil-to-lymphocyte ratio (NLR) and platelet-to-lymphocyte ratio (PLR) may permit to identify patients at greater risk for cerebrovascular events, tailor patient management, improve preoperative status and possibly develop target anti-atherosclerotic therapy. However, studies reporting usefulness of these hematological biomarkers in the context of carotid artery disease are still scarce. The aim of this study was to review the literature concerning the prognostic ability of NLR and PLR in the subpopulation of vascular patients with carotid artery disease.
A Medline search was performed in order to identify publications focused on the physiopathology of NLR and PLR and their impact in the management of patients with carotid artery disease.
The study identified 18 articles with a total of 5339 patients. NLR is associated with carotid intima-media thickness, carotid plaques, carotid stenosis, symptomatic stenosis and intra-stent restenosis after carotid artery stenting and cognitive dysfunction after carotid endarterectomy. PLR is associated with carotid stenosis, symptomatic stenosis and predicts post-operative outcomes after carotid artery revascularization, including post-operative stroke, acute coronary syndrome and all-cause mortality.
The neutrophil-to-lymphocyte ratio (NLR) and platelet-to-lymphocyte ratio (PLR) have the ability to predict sub-clinic atherosclerosis, atherosclerosis progression in carotid artery disease and propensity for carotid stenosis to become symptomatic along with morbidity following CEA and carotid stenting. Consequently, these parameters may be considered to tailored therapy and improve patient management.
炎症是动脉粥样硬化的常见潜在特征。据报道，几种炎症生物标志物在多个领域（包括血管外科）具有预后价值。中性粒细胞与淋巴细胞比值（NLR）和血小板与淋巴细胞比值（PLR）可能有助于识别发生脑血管事件风险更高的患者，调整患者的管理，改善术前状态，并可能开发针对抗动脉粥样硬化的治疗方法。然而，报告这些血液学生物标志物在颈动脉疾病患者中的作用的研究仍然很少。本研究旨在回顾 NLR 和 PLR 在颈动脉疾病血管患者亚组中的预后能力的文献。
进行了 Medline 检索，以确定侧重于 NLR 和 PLR 的生理学和病理学及其对颈动脉疾病患者管理的影响的出版物。
研究共确定了 18 篇文章，共涉及 5339 例患者。NLR 与颈动脉内膜中层厚度、颈动脉斑块、颈动脉狭窄、有症状的狭窄和颈动脉支架置入后的支架内再狭窄以及颈动脉内膜切除术（CEA）后的认知功能障碍有关。PLR 与颈动脉狭窄、有症状的狭窄有关，并预测颈动脉血运重建术后的结果，包括术后中风、急性冠状动脉综合征和全因死亡率。
中性粒细胞与淋巴细胞比值（NLR）和血小板与淋巴细胞比值（PLR）能够预测亚临床动脉粥样硬化、颈动脉疾病中的动脉粥样硬化进展以及颈动脉狭窄向有症状发展的倾向，以及 CEA 和颈动脉支架置入术后的发病率。因此，这些参数可用于个体化治疗并改善患者管理。
