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血管内治疗后急性缺血性脑卒中患者全身炎症反应指数和中性粒细胞与淋巴细胞比值与不良功能结局的关系。

Association of Systemic Inflammatory Response Index and Neutrophil-to-Lymphocyte Ratio on Unfavorable Functional Outcomes in Acute Ischemic Stroke Patients After Endovascular Therapy.

机构信息

Department of Neurology, Affiliated Hospital of Nanjing University of Chinese Medicine, Nanjing, China; Department of Neurology, Jiangsu Province Hospital of Chinese Medicine, Nanjing, China; The First Clinical Medical College, Nanjing University of Chinese Medicine, Nanjing, China; Department of Neurology, Rushan Hospital of Traditional Chinese Medicine, Weihai, China.

Department of Neurology, Affiliated Hospital of Nanjing University of Chinese Medicine, Nanjing, China; Department of Neurology, Rugao Boai hospital, Nantong, China.

出版信息

World Neurosurg. 2024 Oct;190:e1071-e1080. doi: 10.1016/j.wneu.2024.08.065. Epub 2024 Aug 14.

Abstract

BACKGROUND

Inflammatory markers for the prognosis of acute ischemic stroke (AIS) with endovascular therapy remain unclear. The purpose of this study was to investigate the association between the systemic inflammatory response index (SIRI) and neutrophil-to-lymphocyte ratio (NLR) with unfavorable functional outcomes at 90-day in individuals of AIS who underwent endovascular therapy.

METHODS

A total of 128 AIS patients who had endovascular therapy were enrolled from the Nanjing Stroke Registry between September 2019 and November 2022. Peripheral venous blood was collected from patients within 24 h of admission for information on the following parameters: neutrophil count, lymphocyte count, and monocyte count. Then, the SIRI and NLR values were calculated and the association among SIRI, NLR, and modifled Rankin Scale scores 90 days after endovascular therapy was examined via univariate and multivariate logistic analyses. Receiver operating characteristic curves were utilized to determine the best threshold for SIRI and NLR in predicting negative neurological outcomes following endovascular treatment for patients with AIS.

RESULTS

A total of 128 participants were evaluated, among which 50% had unfavorable outcomes. Linear regression analysis showed that the best threshold for SIRI was >1.407 (odds ratio = 1.265; 95% confidence interval, 1.071-1.493; P = 0.006), and for NLR it was >5.347 (odds ratio = 1.088; 95% confidence interval, 1.007-1.175; P = 0.033). These results revealed NLR and SIRI as significant predictors of unfavorable outcomes at 90 days. The area under the curve for SIRI and NLR in predicting 90-day adverse outcomes was 0.643 and 0.609, respectively.

CONCLUSIONS

Higher SIRI and NLR levels at admission may lead to unfavorable outcomes at 90 days for AIS patients with endovascular therapy.

摘要

背景

经血管内治疗的急性缺血性脑卒中(AIS)的预后炎症标志物仍不清楚。本研究旨在探讨血管内治疗后 AIS 患者的全身炎症反应指数(SIRI)和中性粒细胞与淋巴细胞比值(NLR)与 90 天不良功能结局的关系。

方法

2019 年 9 月至 2022 年 11 月,从南京脑卒中登记处共纳入 128 例接受血管内治疗的 AIS 患者。患者入院 24 小时内采集外周静脉血,用于以下参数信息:中性粒细胞计数、淋巴细胞计数和单核细胞计数。然后计算 SIRI 和 NLR 值,并通过单变量和多变量逻辑分析检查 SIRI、NLR 与血管内治疗后 90 天改良 Rankin 量表评分之间的关系。采用受试者工作特征曲线确定 SIRI 和 NLR 预测 AIS 患者血管内治疗后不良神经结局的最佳阈值。

结果

共评估了 128 名参与者,其中 50%的患者预后不良。线性回归分析显示,SIRI 的最佳阈值为>1.407(比值比=1.265;95%置信区间,1.071-1.493;P=0.006),NLR 的最佳阈值为>5.347(比值比=1.088;95%置信区间,1.007-1.175;P=0.033)。这些结果表明 NLR 和 SIRI 是 90 天不良结局的显著预测因子。SIRI 和 NLR 预测 90 天不良结局的曲线下面积分别为 0.643 和 0.609。

结论

血管内治疗后 AIS 患者入院时较高的 SIRI 和 NLR 水平可能导致 90 天预后不良。

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