Juli Cep, Heryaman Henhen, Nazir Arnengsih, Ang Eng-Tat, Defi Irma Ruslina, Gamayani Uni, Atik Nur
Doctoral Program, Faculty of Medicine, Padjadjaran University, Bandung, Indonesia.
Department of Neurology, Dr. Hasan Sadikin General Hospital, Faculty of Medicine, Padjadjaran University, Bandung, Indonesia.
Int J Gen Med. 2021 May 14;14:1843-1851. doi: 10.2147/IJGM.S308325. eCollection 2021.
Inflammation plays an important role and is involved in all stages of acute ischemic stroke. One of these stages involves the recruitment of leukocytes from the peripheral circulation into the ischemic tissue. Lymphocytes as a subtype of leukocytes are important mediators and can become a predictor of neurological outcome. Several studies have been conducted regarding the correlation between differential lymphocyte counts and acute ischemic stroke. Most of these studies analyzed lymphocyte ratio to other leukocyte subtypes such as neutrophils and monocytes. This study specifically observed the role of lymphocytes as an indicator of the inflammatory response in patients with acute ischemic stroke. This study aimed to observe the correlation among risk factors, infarct location, leukocyte counts, lymphocyte value and neurologic output in acute ischemic stroke patients.
We observed and analyzed 193 patients' data from medical record which met the inclusion and exclusion criteria with a diagnosis of acute ischemic stroke at the Department of Neurology of Dr. Hasan Sadikin General Bandung. Data were then analysed using appropriate statistical tests.
Most patients have more than one risk factor with a leukocyte count of less than 10,000 cell/mm. Infarct was mostly located in subcortical area (basal ganglia), with moderate average NIHSS values at admission and at discharge. The number of lymphocytes decreased in the subject group with more than 10,000 cell/mm leukocytes. Subsequently, data were analyzed using Spearman's test and there was a correlation between NIHSS on admission and lymphocyte depletion.
The lymphocyte depletion in patients with leukocytosis is a predictor of poor NIHSS.
炎症在急性缺血性卒中的所有阶段均发挥重要作用并参与其中。其中一个阶段涉及白细胞从外周循环募集至缺血组织。淋巴细胞作为白细胞的一种亚型，是重要的介质，并且可能成为神经功能转归的一个预测指标。关于不同淋巴细胞计数与急性缺血性卒中之间的相关性，已经开展了多项研究。这些研究大多分析了淋巴细胞与其他白细胞亚型（如中性粒细胞和单核细胞）的比例。本研究专门观察了淋巴细胞作为急性缺血性卒中患者炎症反应指标的作用。本研究旨在观察急性缺血性卒中患者的危险因素、梗死部位、白细胞计数、淋巴细胞值与神经功能转归之间的相关性。
我们观察并分析了来自万隆哈桑·萨迪金综合医院神经内科符合纳入和排除标准、诊断为急性缺血性卒中的193例患者的病历数据。然后使用适当的统计检验对数据进行分析。
大多数患者有不止一种危险因素，白细胞计数低于10,000个细胞/mm。梗死大多位于皮质下区域（基底节），入院时和出院时美国国立卫生研究院卒中量表（NIHSS）平均得分中等。白细胞计数超过10,000个细胞/mm的受试者组中淋巴细胞数量减少。随后，使用Spearman检验对数据进行分析，发现入院时的NIHSS与淋巴细胞减少之间存在相关性。
白细胞增多患者的淋巴细胞减少是NIHSS评分不佳的一个预测指标。
