Graduate College, Liaoning University of Traditional Chinese Medicine, Shenyang, China.
Department of Neurology, General Hospital of Northern Theater Command, Shenyang, China.
Brain Behav. 2023 Sep;13(9):e3162. doi: 10.1002/brb3.3162. Epub 2023 Jul 20.
The neutrophil-to-lymphocyte ratio (NLR) has been demonstrated as a prognostic inflammatory biomarker in ischemic stroke. The study aimed to investigate the association of NLR and its dynamic change with long-term outcome and mortality in acute ischemic stroke (AIS) patients who received intravenous thrombolysis (IVT).
From a prospective cohort, AIS patients receiving IVT (alteplase, 0.9 mg/kg) with complete NLR data were retrospectively screened. Based on 3-month modified Rankin scale score (mRS), patients were classified into good group (mRS 0-1) and poor outcome group (mRS 2-6), or survival group (mRS 0-5) and death group (mRS 6). Multivariate logistic regression analysis and receiver operating curve were used to identify prognostic factors and their predictive powers.
A total of 259 eligible patients were enrolled in our study. Logistic regression analysis showed that NLR at 24 h (adjusted odds ratio [aOR] 1.182), 12 days (aOR 1.218) after IVT was independent predictors of 3-month outcome with the AUC of 0.815, 0.820, respectively, whereas NLR at 24 h (aOR 1.17), 12 days (aOR 1.252) after IVT and percentage changes of NLR between admission and 24 h after IVT (aOR 1.214), and between admission and 12 days after IVT (aOR 1.233) were independent predictors of 3-month mortality with the AUCs of 0.86, 0.902, 0.814, and 0.855, respectively.
The comprehensive report suggests that NLR and its dynamic changes are associated with 3-month outcome and mortality in AIS patients after IVT with good predictive powers.
中性粒细胞与淋巴细胞比值（NLR）已被证实是缺血性脑卒中的一种预后炎症生物标志物。本研究旨在探讨接受静脉溶栓（IVT）治疗的急性缺血性脑卒中（AIS）患者的 NLR 及其动态变化与长期预后和死亡率之间的关系。
本研究从前瞻性队列中回顾性筛选出接受 IVT（阿替普酶，0.9mg/kg）且完整 NLR 数据的 AIS 患者。根据 3 个月改良 Rankin 量表评分（mRS），将患者分为预后良好组（mRS 0-1）和预后不良组（mRS 2-6），或生存组（mRS 0-5）和死亡组（mRS 6）。采用多变量逻辑回归分析和受试者工作特征曲线来识别预后因素及其预测能力。
本研究共纳入 259 例符合条件的患者。逻辑回归分析显示，IVT 后 24 小时（调整优势比[aOR]1.182）和 12 天（aOR 1.218）的 NLR 是 3 个月预后的独立预测因素，AUC 分别为 0.815 和 0.820。IVT 后 24 小时（aOR 1.17）、12 天（aOR 1.252）的 NLR 和 NLR 从入院到 IVT 后 24 小时的变化百分比（aOR 1.214）以及从入院到 IVT 后 12 天的变化百分比（aOR 1.233）也是 3 个月死亡率的独立预测因素，AUC 分别为 0.86、0.902、0.814 和 0.855。
综合报告表明，NLR 及其动态变化与 IVT 后 AIS 患者的 3 个月预后和死亡率相关，具有较好的预测能力。
