Department of Neurology, Ajou University School of Medicine, Ajou University Medical Center, 164, World Cup-Ro, Yeongtong-Gu, Suwon, Republic of Korea.
Ajou University School of Medicine, Suwon, Republic of Korea.
BMC Neurol. 2023 Sep 25;23(1):336. doi: 10.1186/s12883-023-03384-3.
The neutrophil-to-lymphocyte ratio (NLR) has been found to be useful in the prognostication of immune-mediated neurological disorders because it roughly reflects the systemic innate immune response compared to the adaptive immune response. However, studies on the validity of NLR in demyelinating disorders of the central nervous system have shown conflicting results. Therefore, we aimed to investigate NLR in the idiopathic transverse myelitis (ITM) cohort.
We retrospectively analyzed the cohort data of patients with ITM between January 2006 and February 2020. The medical data of all patients with myelitis were reviewed to exclude patients with disease-associated myelopathy according to predefined exclusion criteria. The relationship between the natural log-transformed NLR (lnNLR) and the clinical, paraclinical, and imaging data was evaluated. Factors associated with neurological disability were analyzed using a linear mixed-effects model. Predictive factors for moderate-to-severe neurological disability (Expanded Disability Status Scale [EDSS] score ≥ 4) were investigated.
A total of 124 participants were included in the analysis. The lnNLR correlated with EDSS and lesion length. Linear mixed-effects analysis showed that age, lesion length, and lnNLR were independently associated with neurological disabilities. Multivariable logistic regression revealed that lnNLR (odds ratio [OR] = 4.266, 95% confidence interval [CI] = 1.220-14.912, p = 0.023) and lesion length (OR = 1.848, 95% CI = 1.249-2.734, p = 0.002) were independent predictive factors of the worst neurological disability.
NLR may be used as an independent prognostic factor for predicting poor neurological outcomes in patients with ITM.
中性粒细胞与淋巴细胞比值（NLR）已被证明在免疫介导的神经疾病的预后中有一定作用，因为它大致反映了全身固有免疫反应，而不是适应性免疫反应。然而，关于 NLR 在中枢神经系统脱髓鞘疾病中的有效性的研究结果存在矛盾。因此，我们旨在研究特发性横贯性脊髓炎（ITM）患者的 NLR。
我们回顾性分析了 2006 年 1 月至 2020 年 2 月期间 ITM 患者的队列数据。对所有脊髓炎患者的医疗数据进行了回顾，根据预先设定的排除标准排除与疾病相关的脊髓病患者。评估自然对数转换后的 NLR（lnNLR）与临床、临床前和影像学数据之间的关系。使用线性混合效应模型分析与神经功能障碍相关的因素。研究中探讨了中度至重度神经功能障碍（扩展残疾状态量表[EDSS]评分≥4）的预测因素。
共有 124 名参与者被纳入分析。lnNLR 与 EDSS 和病变长度相关。线性混合效应分析表明，年龄、病变长度和 lnNLR 与神经功能障碍独立相关。多变量逻辑回归显示，lnNLR（比值比[OR] = 4.266，95%置信区间[CI] = 1.220-14.912，p = 0.023）和病变长度（OR = 1.848，95% CI = 1.249-2.734，p = 0.002）是预测最差神经功能结局的独立预测因素。
NLR 可作为预测 ITM 患者不良神经结局的独立预后因素。
