Department of Neurology, The Second Affiliated Hospital of Soochow University, Suzhou, Jiangsu Province, 215004, China.
Department of Neurology, The Nuclear Industry 417 Hospital, Xi'an, Shanxi Province, 710600, China.
BMC Neurol. 2024 May 31;24(1):183. doi: 10.1186/s12883-024-03628-w.
Serum uric acid (UA) and the neutrophil-to-lymphocyte ratio (NLR) have been reported to be associated with outcomes in acute ischemic stroke (AIS). However, whether UA is related to the prognosis of AIS patients undergoing intravenous thrombolysis (IVT) remains inconclusive. We sought to explore the combined effect of UA and NLR on the prognosis of AIS treated with IVT.
A total of 555 AIS patients receiving IVT treatment were enrolled. Patients were categorized into four groups according to the levels of UA and NLR: LNNU (low NLR and normal UA), LNHU (low NLR and high UA), HNNU (high NLR and normal UA), and HNHU (high NLR and high UA). Multivariable logistic regression analysis was used to evaluate the value of serum UA level and NLR in predicting prognosis. The primary outcomes were major disability (modified Rankin scale (mRS) score 3-5) and death within 3 months.
After multivariate adjustment, a high NLR (≥ 3.94) increased the risk of 3-month death or major disability (OR, 2.23; 95% CI, 1.42 to 3.55, p < 0.001). However, there was no statistically significant association between a high UA level (≥ 313.00 µmol/L) and clinical outcome. HNHU was associated with a 5.09-fold increase in the risk of death (OR, 5.09; 95% CI, 1.31-19.83; P value = 0.019) and a 1.98-fold increase in the risk of major disability (OR, 1.98; 95% CI 1.07-3.68; P value = 0.030) in comparison to LNNU.
High serum UA levels combined with high NLR were independently associated with 3-month death and major disability in AIS patients after IVT.
血清尿酸（UA）和中性粒细胞与淋巴细胞比值（NLR）已被报道与急性缺血性脑卒中（AIS）的结局相关。然而，UA 是否与接受静脉溶栓（IVT）治疗的 AIS 患者的预后相关仍不确定。我们旨在探讨 UA 和 NLR 联合对接受 IVT 治疗的 AIS 患者预后的影响。
共纳入 555 例接受 IVT 治疗的 AIS 患者。根据 UA 和 NLR 的水平，将患者分为四组：LNNU（低 NLR 和正常 UA）、LNHU（低 NLR 和高 UA）、HNNU（高 NLR 和正常 UA）和 HNHU（高 NLR 和高 UA）。采用多变量 logistic 回归分析评估血清 UA 水平和 NLR 预测预后的价值。主要结局为 3 个月时的重度残疾（改良 Rankin 量表（mRS）评分 3-5）和死亡。
多变量调整后，高 NLR（≥3.94）增加了 3 个月死亡或重度残疾的风险（OR，2.23；95%CI，1.42-3.55，p<0.001）。然而，高 UA 水平（≥313.00 μmol/L）与临床结局之间无统计学显著关联。与 LNNU 相比，HNHU 与死亡风险增加 5.09 倍（OR，5.09；95%CI，1.31-19.83；P 值=0.019）和重度残疾风险增加 1.98 倍（OR，1.98；95%CI，1.07-3.68；P 值=0.030）相关。
在接受 IVT 治疗的 AIS 患者中，高血清 UA 水平联合高 NLR 与 3 个月时的死亡和重度残疾独立相关。
