Department of Radiology, 6915Mayo Clinic, Rochester, MN, USA.
Department of Neurosurgery, 6915Mayo Clinic, Rochester, MN, USA.
Interv Neuroradiol. 2022 Dec;28(6):726-730. doi: 10.1177/15910199211065530. Epub 2021 Dec 8.
BACKGROUND & PURPOSE: It has been hypothesized that circulating neutrophils have a direct correlation with the composition of emboli in acute ischemic stroke (AIS). The aim of this study is to evaluate the association between neutrophil-lymphocyte ratio (NLR) in peripheral blood and the expression of neutrophil extracellular traps (NETs) within stroke emboli.
Consecutive patients with acute ischemic stroke (AIS) due to large vessel occlusion (LVO) that underwent mechanical thrombectomy (MT) were included. Patients were divided into two groups based on NLR median value. Retrieved thrombi were histologically analyzed using Martius Scarlett Blue (MSB) for main thrombus components including red blood cells (RBCs), white blood cells (WBCs), fibrin and platelet. Immunohistochemistry staining for von Willebrand Factor (vWF) and anti-citrullinated H3 (H3Cit; NETs marker) was also performed.
Samples from a total of 84 patients were included. The average percentage of RBCs, WBCs, fibrin, platelet, H3Cit, and vWF components in thrombi were 45.1%, 3.5%, 21.8%, 29.6%, 19.7% and 14.8% respectively. When stratifying by NLR group [low (≤3.94) versus high (>3.95)], high NLR group had significantly more WBCs (4.5%), fibrin (24.2%), H3Cit (22.7%) and vWF (17.1%) thrombus fractions compared to low NLR group. Additionally, RBC content (38.8%) was lower in the high NLR group.
NLR is correlated with the amounts of WBCs, fibrin, NETs and vWF within the thrombi retrieved from AIS patients due to LVO.
据推测，循环中性粒细胞与急性缺血性脑卒中（AIS）中的栓子组成有直接关联。本研究旨在评估外周血中性粒细胞与淋巴细胞比值（NLR）与卒中栓子中中性粒细胞胞外诱捕网（NETs）表达之间的相关性。
连续纳入因大血管闭塞（LVO）而行机械血栓切除术（MT）的急性缺血性卒中（AIS）患者。根据 NLR 中位数将患者分为两组。使用 Martius Scarlet Blue（MSB）对血栓的主要血栓成分（包括红细胞 [RBCs]、白细胞 [WBCs]、纤维蛋白和血小板）进行组织学分析。还进行了抗 von Willebrand 因子（vWF）和抗瓜氨酸化 H3（H3Cit；NETs 标志物）免疫组织化学染色。
共纳入 84 例患者的样本。血栓中 RBCs、WBCs、纤维蛋白、血小板、H3Cit 和 vWF 成分的平均百分比分别为 45.1%、3.5%、21.8%、29.6%、19.7%和 14.8%。按 NLR 组[低（≤3.94）与高（>3.95）]分层时，与低 NLR 组相比，高 NLR 组的 WBCs（4.5%）、纤维蛋白（24.2%）、H3Cit（22.7%）和 vWF（17.1%）血栓成分明显更多。此外，高 NLR 组 RBC 含量（38.8%）较低。
NLR 与 LVO 所致 AIS 患者血栓中 WBCs、纤维蛋白、NETs 和 vWF 的含量相关。
