Department of Neurology, Centro Hospitalar Universitário de São João, EPE, Department of Clinical Neurosciences and Mental Health, Faculty of Medicine of University of Porto.
Department of Neurology, Centro Hospitalar Universitário de São João, EPE, Department of Clinical Neurosciences and Mental Health, Faculty of Medicine of University of Porto.
J Stroke Cerebrovasc Dis. 2021 Jul;30(7):105844. doi: 10.1016/j.jstrokecerebrovasdis.2021.105844. Epub 2021 May 11.
We aimed to analyse the relationship between specific inflammatory biomarkers' levels and the temporal pattern of cerebral venous thrombosis (CVT) symptoms.
We performed a retrospective study of adult CVT patients admitted between Jan 01 2006 and Dec 31 2019. We excluded patients with infection at admission, autoimmune, inflammatory or haematological disorders. We evaluated serum inflammatory biomarkers at admission: C-reactive protein (CRP), erythrocyte sedimentation rate (ESR), absolute neutrophil count, absolute lymphocyte count, platelet count, monocyte count, neutrophile-to-lymphocyte ratio (NLR), lymphocyte-to-monocyte ratio (LMR), platelet-to-lymphocyte ratio (PLR), bilirubin and monocyte-to-HDL ratio (M-HDLR). These were evaluated according to the time from symptom onset (acute, subacute or chronic).
We included 78 patients with CVT (mean age 41 ± 13 years). Neutrophil count (p = 0.017), monocyte (p = 0.024), CRP (p = 0.004), NLR (p<0.001) and LMR (p = 0.004) showed significant variation with CVT duration. Acute onset CVT exhibited higher absolute neutrophil count and NLR but lower LMR. The subacute group had higher monocyte values, and the chronic phase patients displayed higher LMR, but lower CRP. ESR, PLR and M-HDLR showed a tendency to decrease in the chronic phase. We did not observe any statistical difference between the duration of symptoms and levels of bilirubin.
CVT patients present a differential inflammatory pattern along the time course of the disease: higher NLR and lower LMR in acute phase, and higher LMR and lower CRP level during the chronic phase. These differences may help to ascertain the onset of poorly defined symptoms and provide input regarding anticoagulation management.
分析特定炎症生物标志物水平与脑静脉血栓形成（CVT）症状时间模式之间的关系。
我们对 2006 年 1 月 1 日至 2019 年 12 月 31 日期间住院的成年 CVT 患者进行了回顾性研究。排除入院时存在感染、自身免疫、炎症或血液系统疾病的患者。我们评估了入院时的血清炎症生物标志物：C 反应蛋白（CRP）、红细胞沉降率（ESR）、绝对中性粒细胞计数、绝对淋巴细胞计数、血小板计数、单核细胞计数、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）、血小板与淋巴细胞比值（PLR）、胆红素和单核细胞与高密度脂蛋白比值（M-HDLR）。根据症状发作（急性、亚急性或慢性）的时间来评估这些标志物。
我们纳入了 78 例 CVT 患者（平均年龄 41 ± 13 岁）。中性粒细胞计数（p = 0.017）、单核细胞（p = 0.024）、CRP（p = 0.004）、NLR（p<0.001）和 LMR（p = 0.004）随着 CVT 持续时间的变化而显著变化。急性发作的 CVT 表现出更高的绝对中性粒细胞计数和 NLR，但 LMR 更低。亚急性组的单核细胞值更高，慢性期患者的 LMR 更低，但 CRP 更低。ESR、PLR 和 M-HDLR 在慢性期呈下降趋势。我们没有观察到胆红素水平与症状持续时间之间存在任何统计学差异。
CVT 患者在疾病过程中表现出不同的炎症模式：急性期 NLR 较高而 LMR 较低，慢性期 LMR 较高而 CRP 水平较低。这些差异可能有助于确定症状的起始时间，并为抗凝治疗管理提供参考。
