Zhang Ya Xin, Shen Zhi Yuan, Jia Yi Cun, Guo Xin, Guo Xiao Su, Xing Yuan, Tian Shu Juan
Department of Neurology, The First Hospital of Hebei Medical University, Shijiazhuang, Hebei, People's Republic of China.
Department of Neurology, Hebei Hospital, Xuanwu Hospital, Capital Medical University, Shijiazhuang, Hebei, People's Republic of China.
J Inflamm Res. 2023 Aug 23;16:3619-3630. doi: 10.2147/JIR.S418106. eCollection 2023.
The aim of this study was to explore the relationship between functional prognosis and the neutrophil-to-lymphocyte ratio (NLR), platelet-to-lymphocyte ratio (PLR), lymphocyte-to-monocyte ratio (LMR) and systemic inflammatory response index (SIRI) in patients with acute ischemic stroke (AIS) at discharge.
A total of 861 patients with AIS were enrolled between January 2019 and December 2021. Blood cell counts were collected on admission. Logistic regression analysis was performed to assess the relationship between NLR, PLR, LMR, SIRI and adverse functional outcomes (modified Rankin scale score of 3-6) at discharge. We also used receiver operating characteristic (ROC) curves to estimate the overall ability of NLR, PLR, LMR and SIRI to judge short-term functional outcomes. Associations between NLR, PLR, LMR, and SIRI with length of hospital stay were analyzed by Spearman correlation test.
A total of 194 patients (22.5%) had poor functional outcomes at discharge. Multivariate logistic regression analysis showed that NLR (odds ratio [OR], 1.060; 95% confidence interval [CI] 1.004-1.120, P=0.037), PLR (OR, 1.003; 95% CI 1.000-1.005, P=0.018), LMR (OR, 0.872; 95% CI 0.774-0.981, P=0.023) and SIRI (OR, 1.099; 95% CI 1.020-1.184, P=0.013) were independent factors for poor functional outcome. The odds ratios of the highest versus lowest quartiles of NLR, PLR and SIRI were 2.495 (95% CI 1.394-4.466), 1.959 (95% CI 1.138-3.373) and 1.866 (95% CI 1.106-3.146), respectively. The odds ratio of the lowest versus highest quartile of LMR was 2.300 (95% CI 1.331-3.975). The areas under the curve (AUCs) of the NLR, PLR, LMR, and SIRI to discriminate poor functional prognosis were 0.644, 0.587, 0.628, and 0.651, respectively. NLR, LMR, and SIRI were related with the length of hospital stay (P<0.05).
NLR, PLR, LMR, and SIRI were associated with functional outcome at discharge in AIS patients. NLR, LMR and SIRI were related to hospitalization days in patients with AIS.
本研究旨在探讨急性缺血性卒中（AIS）患者出院时功能预后与中性粒细胞与淋巴细胞比值（NLR）、血小板与淋巴细胞比值（PLR）、淋巴细胞与单核细胞比值（LMR）及全身炎症反应指数（SIRI）之间的关系。
2019年1月至2021年12月共纳入861例AIS患者。入院时采集血细胞计数。进行逻辑回归分析以评估NLR、PLR、LMR、SIRI与出院时不良功能结局（改良Rankin量表评分为3 - 6分）之间的关系。我们还使用受试者工作特征（ROC）曲线来评估NLR、PLR、LMR和SIRI判断短期功能结局的总体能力。通过Spearman相关性检验分析NLR、PLR、LMR和SIRI与住院时间的相关性。
共有194例患者（22.5%）出院时功能预后不良。多因素逻辑回归分析显示，NLR（比值比[OR]，1.060；95%置信区间[CI] 1.004 - 1.120，P = 0.037）、PLR（OR，1.003；95% CI 1.000 - 1.005，P = 0.018）、LMR（OR，0.872；95% CI 0.774 - 0.981，P = 0.023）和SIRI（OR，1.099；95% CI 1.020 - 1.184，P = 0.013）是功能预后不良的独立因素。NLR、PLR和SIRI最高四分位数与最低四分位数的比值比分别为2.495（95% CI 1.394 - 4.466）、1.959（95% CI 1.138 - 3.373）和1.866（95% CI 1.106 - 3.146）。LMR最低四分位数与最高四分位数的比值比为2.300（95% CI 1.331 - 3.975）。NLR、PLR、LMR和SIRI鉴别不良功能预后的曲线下面积（AUC）分别为0.644、0.587、0.628和0.651。NLR、LMR和SIRI与住院时间相关（P < 0.05）。
NLR、PLR、LMR和SIRI与AIS患者出院时的功能结局相关。NLR、LMR和SIRI与AIS患者的住院天数相关。
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