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低淋巴细胞与单核细胞比值可能是机械取栓术后急性缺血性脑卒中患者不良临床结局的预测指标。

Low Lymphocyte-to-Monocyte Ratio as a Possible Predictor of an Unfavourable Clinical Outcome in Patients with Acute Ischemic Stroke after Mechanical Thrombectomy.

作者信息

Pinčáková Katarína, Krastev Georgi, Haring Jozef, Mako Miroslav, Mikulášková Viktória, Bošák Vladimír

机构信息

Department of Laboratory Medicine, Faculty of Health and Social Care, Trnava University in Trnava, 918 43 Trnava, Slovakia.

Department of Haematology, Faculty Hospital Trnava, 917 75 Trnava, Slovakia.

出版信息

Stroke Res Treat. 2022 Dec 10;2022:9243080. doi: 10.1155/2022/9243080. eCollection 2022.

Abstract

BACKGROUND

Although considerable progress has been made in the treatment of acute ischemic stroke (AIS), the clinical outcome of patients is still significantly influenced by the inflammatory response that follows stroke-induced brain injury. The aim of this study was to evaluate the potential use of complete blood count parameters, including indices and ratios, for predicting the clinical outcome in AIS patients undergoing mechanical thrombectomy (MT).

METHODS

This single-centre retrospective study is consisted of 179 patients. Patient data including demographic characteristics, risk factors, clinical data, laboratory parameters on admission, and clinical outcome were collected. Based on the clinical outcome assessed at 3 months after MT by the modified Rankin Scale (mRS), patients were divided into two groups: the favourable group (mRS 0-2) and unfavourable group (mRS 3-6). Stepwise multivariate logistic regression analysis was used to detect an independent predictor of the unfavourable clinical outcome.

RESULTS

An unfavourable clinical outcome was detected after 3 months in 101 patients (54.4%). Multivariate logistic regression analysis confirmed that the lymphocyte-to-monocyte ratio (LMR) was an independent predictor of unfavourable clinical outcome at 3 months (odds ratio = 0.761, 95% confidence interval 0.625-0.928, and = 0.007). The value of 3.27 was chosen to be the optimal cut-off value of LMR. This value could predict the unfavourable clinical outcome with a 74.0% sensitivity and a 54.4% specificity.

CONCLUSION

The LMR at the time of hospital admission is a predictor of an unfavourable clinical outcome at 3 months in AIS patients after MT.

摘要

背景

尽管急性缺血性卒中(AIS)的治疗已取得显著进展,但卒中所致脑损伤后的炎症反应仍对患者的临床结局有重大影响。本研究旨在评估全血细胞计数参数(包括各项指标和比值)在预测接受机械取栓(MT)的AIS患者临床结局方面的潜在用途。

方法

这项单中心回顾性研究纳入了179例患者。收集了患者的数据,包括人口统计学特征、危险因素、临床数据、入院时的实验室参数以及临床结局。根据MT术后3个月采用改良Rankin量表(mRS)评估的临床结局,将患者分为两组:预后良好组(mRS 0 - 2)和预后不良组(mRS 3 - 6)。采用逐步多因素逻辑回归分析来检测不良临床结局的独立预测因素。

结果

101例患者(54.4%)在3个月后出现不良临床结局。多因素逻辑回归分析证实,淋巴细胞与单核细胞比值(LMR)是3个月时不良临床结局的独立预测因素(比值比 = 0.761,95%置信区间0.625 - 0.928,P = 0.007)。选择3.27作为LMR的最佳截断值。该值预测不良临床结局的灵敏度为74.0%,特异度为54.4%。

结论

入院时的LMR是MT术后AIS患者3个月时不良临床结局的预测指标。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/62e8/9759396/1d2f399f4d52/SRT2022-9243080.001.jpg

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