Zhang Qingyan, Ma Danyue, Du Hebin, Wang Tiantian, Li Wei
Key Laboratory of Ultra-Weak Magnetic Field Measurement Technology, Ministry of Education, School of Instrumentation and Optoelectronic Engineering, Beihang University, Beijing, 100191, People's Republic of China.
Zhejiang Provincial Key Laboratory of Ultra-Weak Magnetic-Field Space and Applied Technology, Hangzhou Innovation Institute of Beihang University, Hangzhou, 310000, People's Republic of China.
Int J Gen Med. 2024 Dec 14;17:6199-6206. doi: 10.2147/IJGM.S486511. eCollection 2024.
To assess the value of combination of white matter hyperintensity (WMH) and neutrophil-to-lymphocyte ratio (NLR) in predicting short-term prognosis of acute ischemic stroke (AIS) patients.
Three hundred and nine AIS patients were included in this prospective observational research. They were evaluated at 3-month after the onset of AIS using modified Rankin Scale (mRS) score. A mRS score of 0-2 was defined as a favourable outcome, while an mRS score of 3-6 was defined as an unfavourable outcome. Multivariate analysis was used to identify the independent associations of WMH and NLR with short-term prognosis of AIS patients, and receiver operating characteristic (ROC) curves were used to evaluate the predictive values of WMH, NLR and their combination for short-term prognosis of AIS patients, and test was used to compare the area under curve (AUC).
Among 309 AIS patients, 201 (65.0%) had a favorable 3-month outcome, while 108 (35.0%) had an unfavorable outcome. According to the results of multivariate analysis, WMH, NLR and on-admission NIHSS score were independently associated with unfavourable outcome of AIS after adjusting for diabetes mellitus, atrial fibrillation, TOAST subtype and LDL-cholesterol. ROC curves showed that the AUCs of WMH, NLR and their combination for predicting short-term prognosis of AIS patients were 0.760 [standard error (): 0.029, 95% confidence interval (): 0.703-0.817, <0.001], 0.717 (: 0.030, 95% : 0.661-0.774, <0.001) and 0.906 (: 0.019, 95% : 0.868-0.944, <0.001), respectively. The AUC of combination prediction was significantly higher than those of individual predictions (0.906 0.760, =4.211, <0.001; 0.906 vs 0.717, =5.322, <0.001).
WMH and NLR were independently associated with short-term prognosis of AIS patients, and the combination of WMH and NLR could be applied in predicting short-term prognosis of AIS patients, having a high predictive value.
评估脑白质高信号（WMH）与中性粒细胞与淋巴细胞比值（NLR）相结合在预测急性缺血性脑卒中（AIS）患者短期预后中的价值。
本前瞻性观察性研究纳入了309例AIS患者。在AIS发病后3个月时，使用改良Rankin量表（mRS）评分对他们进行评估。mRS评分为0 - 2被定义为良好预后，而mRS评分为3 - 6被定义为不良预后。采用多因素分析来确定WMH和NLR与AIS患者短期预后的独立关联，并使用受试者工作特征（ROC）曲线来评估WMH、NLR及其组合对AIS患者短期预后的预测价值，采用检验来比较曲线下面积（AUC）。
在309例AIS患者中，201例（65.0%）在3个月时有良好预后，而108例（35.0%）有不良预后。根据多因素分析结果，在调整了糖尿病、心房颤动、TOAST亚型和低密度脂蛋白胆固醇后，WMH、NLR和入院时美国国立卫生研究院卒中量表（NIHSS）评分与AIS不良预后独立相关。ROC曲线显示，WMH、NLR及其组合预测AIS患者短期预后的AUC分别为0.760[标准误（SE）：0.029，95%置信区间（CI）：0.703 - 0.817，P<0.001]、0.717（SE：0.030，95%CI：0.661 - 0.774，P<0.001）和0.906（SE：0.019，95%CI：0.868 - 0.944，P<0.001）。联合预测的AUC显著高于单独预测的AUC（0.906对0.760，Z = 4.211，P<0.001；0.906对0.717，Z = 5.322，P<0.001）。
WMH和NLR与AIS患者短期预后独立相关，WMH与NLR的组合可用于预测AIS患者的短期预后，具有较高的预测价值。
