Wang Qi, Li Wen-Na, Otkur Wuxiyar, Cui Yu, Chen Hui-Sheng
Department of Neurology, General Hospital of Northern Theater Command, Shenyang, 110016, People's Republic of China.
Dalian Medical University, Dalian, People's Republic of China.
J Inflamm Res. 2024 Aug 20;17:5543-5553. doi: 10.2147/JIR.S460928. eCollection 2024.
We conducted a post-hoc analysis of the RICAMIS trial to investigate the effect of neutrophil-to-lymphocyte ratio (NLR), platelet-to-lymphocyte ratio (PLR), and systemic immune inflammation index (SII) on the efficacy of remote ischemic conditioning treatment.
In this post-hoc analysis, NLR, PLR, and SII were measured before randomization. Patients were divided into two groups based on their cut-off values: high vs low NLR, high vs low PLR, and high vs low SII groups. Each group was further subdivided into RIC and control groups. The primary endpoint was a poor outcome (mRS 2-6 at 90 days). Differences in the primary endpoint between the RIC and control subgroups were compared, and the interactions of treatment assignment with NLR, PLR, and SII were evaluated.
A total of 1679 patients were included in the final analysis. Compared with the control group, RIC significantly improved functional outcomes regardless of the inflammation status. The improved probability of poor outcome in the RIC vs control group was numerically greater in the high vs low inflammation group (NLR, 7.8% vs 5.1%; PLR, 7% vs 6.5%; SII, 9% vs 5.3%). However, we did not find an interaction effect of an intervention (RIC or control) with different NLR, PLR, or SII on clinical outcomes (P > 0.05). In addition, the NLR and SII were independently associated with functional outcomes in all patients, regardless of whether they received RIC.
Inflammation may not affect the efficacy of RIC in patients with acute moderate ischemic stroke, although a lower probability of poor outcome at 90 days was identified in patients with a high vs low inflammatory status.
我们对RICAMIS试验进行了事后分析，以研究中性粒细胞与淋巴细胞比值（NLR）、血小板与淋巴细胞比值（PLR）和全身免疫炎症指数（SII）对远程缺血预处理治疗疗效的影响。
在这项事后分析中，在随机分组前测量NLR、PLR和SII。根据临界值将患者分为两组：高NLR组与低NLR组、高PLR组与低PLR组、高SII组与低SII组。每组再进一步分为远程缺血预处理组和对照组。主要终点是不良结局（90天时改良Rankin量表评分2 - 6分）。比较远程缺血预处理组和对照组亚组之间主要终点的差异，并评估治疗分配与NLR、PLR和SII的相互作用。
共有1679例患者纳入最终分析。与对照组相比，无论炎症状态如何，远程缺血预处理均显著改善了功能结局。高炎症组与低炎症组相比，远程缺血预处理组与对照组相比不良结局改善的概率在数值上更高（NLR，7.8%对5.1%；PLR，7%对6.5%；SII，9%对5.3%）。然而，我们未发现不同NLR、PLR或SII的干预措施（远程缺血预处理或对照）对临床结局有交互作用（P>0.05）。此外，无论患者是否接受远程缺血预处理，NLR和SII均与所有患者的功能结局独立相关。
炎症可能不影响急性中度缺血性卒中患者远程缺血预处理的疗效，尽管在高炎症状态与低炎症状态的患者中，90天时不良结局的概率较低。
