Li Xiaoqiang, Zhou Xiangmao, Wang Hui, Ruan Baifu, Song Zhibin, Zhang Guifeng
Department of Neurology, Xiaolan People's Hospital of Zhongshan (The Fifth People's Hospital of Zhongshan), Zhongshan, Guangdong, China.
Department of Gastrointestinal Surgery, The Central Hospital of Yongzhou, Yongzhou, Hunan, China.
PeerJ. 2024 Sep 19;12:e18066. doi: 10.7717/peerj.18066. eCollection 2024.
Stroke-associated pneumonia (SAP) is a common complication of acute ischemic stroke (AIS) and is associated with increased mortality and prolonged hospital stays. The lymphocyte-to-monocyte ratio (LMR) is a novel inflammatory marker that has been shown to be associated with various diseases. However, the relationship between the LMR and SAP in patients with AIS remains unclear.
A retrospective cohort study was conducted on 1,063 patients with AIS admitted to our hospital within 72 hours of symptom onset. Patients were divided into two groups: the SAP group ( = 99) and the non-SAP group ( = 964). The LMR was measured within 24 hours of admission, and the primary outcome was the incidence of SAP. We used univariate and multivariate logistic regression analyses to assess the relationship between the LMR and SAP. Additionally, curve-fitting techniques and subgroup analyses were conducted.
The incidence of SAP was 9.31%. We found that the LMR was significantly lower in the SAP group than in the non-SAP group (2.46 ± 1.44 3.86 ± 1.48, < 0.001). A nonlinear relationship was observed between the LMR and the incidence of SAP. Subgroup analysis revealed that an elevated LMR was associated with a reduced incidence of SAP in individuals with an LMR below 4. Multivariate logistic regression analysis demonstrated that LMR was an independent predictor of SAP (OR = 0.37, 95% CI [0.27-0.53]).
Our study suggests that the LMR is an independent predictor of SAP in patients with AIS, particularly when the LMR is less than 4. The LMR may serve as a promising biomarker for the early identification of patients with AIS at a high risk of SAP.
卒中相关性肺炎（SAP）是急性缺血性卒中（AIS）的常见并发症，与死亡率增加和住院时间延长相关。淋巴细胞与单核细胞比值（LMR）是一种新型炎症标志物，已被证明与多种疾病相关。然而，AIS患者中LMR与SAP之间的关系仍不明确。
对我院在症状发作72小时内收治的1063例AIS患者进行回顾性队列研究。患者分为两组：SAP组（n = 99）和非SAP组（n = 964）。入院24小时内测量LMR，主要结局是SAP的发生率。我们采用单因素和多因素逻辑回归分析来评估LMR与SAP之间的关系。此外，还进行了曲线拟合技术和亚组分析。
SAP的发生率为9.31%。我们发现，SAP组的LMR显著低于非SAP组（2.46±1.44对3.86±1.48，P<0.001）。观察到LMR与SAP发生率之间存在非线性关系。亚组分析显示，LMR低于4的个体中，LMR升高与SAP发生率降低相关。多因素逻辑回归分析表明，LMR是SAP的独立预测因子（OR = 0.37，95%CI[0.27 - 0.53]）。
我们的研究表明，LMR是AIS患者SAP的独立预测因子，尤其是当LMR小于4时。LMR可能是早期识别AIS合并SAP高风险患者的有前景的生物标志物。
