Department of Neurosurgery, West China Hospital, Sichuan University, Chengdu, Sichuan, China.
National Drug Clinical-Trial institution of West China Second Hospital, Sichuan University, Chengdu, China.
Brain Behav. 2023 Nov;13(11):e3261. doi: 10.1002/brb3.3261. Epub 2023 Sep 24.
The objective of the present research was to examine the correlation between the neutrophil-to-lymphocyte ratio (NLR) and stroke progression (SP) as well as the functional outcome following an ischemic stroke (IS).
The current study was conducted as prospective observational research. A cohort of 341 participants diagnosed with IS was included in the study from March 2019 to August 2021. This study's primary measure of interest was the occurrence of SP within the initial week following hospital admission. The secondary outcome was functional status 3 months after IS as measured by a modified Rankin scale score. The association between NLR with SP, and poor functional outcomes was examined using multivariate logistic regression. The predictive value of NLR for SP and poor functional outcomes was evaluated using the receiver operating characteristic (ROC) curve.
Among the 341 enrolled patients, 56 (16.4%) had SP, and 285 (83.6%) had no SP. The results of the multivariate logistic regression analysis demonstrated that the existence of diabetes mellitus and the NLR were independently associated with SP and poor functional outcomes. The area under the ROC curve of NLR in predicting poor functional outcome was 0.6117 (95% confidence interval, .5341-.6893, p = .0032), and the optimal cut-off point was 4.2139. The sensitivity and specificity of NLR in predicting poor functional outcomes were 52.7% and 72.0%, respectively.
Patients with acute IS exhibited a very high incidence of SP. NLR may be a valuable prognostic indicator in clinical practice because it was independently associated with SP and a poor functional outcome.
本研究旨在探讨中性粒细胞与淋巴细胞比值（NLR）与缺血性脑卒中（IS）患者病情进展（SP）以及功能结局之间的相关性。
本研究为前瞻性观察性研究。纳入 2019 年 3 月至 2021 年 8 月期间诊断为 IS 的 341 名患者。本研究的主要观察指标为入院后第 1 周内发生 SP。次要结局为 IS 后 3 个月的功能状态，采用改良 Rankin 量表评分。采用多变量逻辑回归分析 NLR 与 SP 和不良功能结局的关系。采用受试者工作特征（ROC）曲线评估 NLR 对 SP 和不良功能结局的预测价值。
在纳入的 341 名患者中，56 名（16.4%）发生 SP，285 名（83.6%）未发生 SP。多变量逻辑回归分析结果显示，糖尿病和 NLR 与 SP 和不良功能结局独立相关。NLR 预测不良功能结局的 ROC 曲线下面积为 0.6117（95%置信区间，0.5341-0.6893，p=0.0032），最佳截断值为 4.2139。NLR 预测不良功能结局的敏感性和特异性分别为 52.7%和 72.0%。
急性 IS 患者 SP 发生率很高。NLR 可能是临床实践中有价值的预后指标，因为它与 SP 和不良功能结局独立相关。
