Liu Keting, Yang Li, Liu Yang, Zhang Yun, Zhu Juncheng, Zhang Haofeng, He Zemin
Department of Neurology, Chengdu Seventh People's Hospital (Affiliated Cancer Hospital of Chengdu Medical College), Chengdu, Sichuan Province, 610213, People's Republic of China.
Nanfang Hospital, Southern Medical University, Guangzhou, Guangdong Province, 510515, People's Republic of China.
J Inflamm Res. 2025 Jan 7;18:195-202. doi: 10.2147/JIR.S500474. eCollection 2025.
Systemic immune-inflammation index (SII) and neutrophil-to-lymphocyte ratio (NLR) are novel inflammatory markers based on neutrophil, platelet and lymphocyte counts. Atherosclerosis is a chronic inflammatory vascular disease. This study aimed to verify the predictive value of the clinical parameters such as systemic immune-inflammation index (SII) and neutrophil-to-lymphocyte ratio (NLR) for the severity in Large Artery Atherosclerosis (LAA) stroke patients.
The SII is defined as platelet × (neutrophil count/lymphocyte count), the NLR is defined as neutrophil count/lymphocyte count. Univariate logistic regression was used to analyze the association between SII and NLR and NIHSS score in patients with LAA stroke. Multiple logistic regression was used to analyze the risk factors for the severity of LAA stroke. We plotted receiver operating characteristic curves to determine the diagnostic role of SII and NLR in differentiating stroke disease severity.
We included 283 LAA stroke patients, the SII and NLR in the moderate-to-severe stroke group were significantly higher than the mild stroke group. Multiple logistic regression analysis showed that SII (OR 1.051 95% CI (1.035-1.066), P < 0.001), NLR (OR 1.077,95% CI (1.032-1.123), P < 0.001) were significantly associated with stroke severity. The SII values under the receiver operating characteristic curve (0.701, 95% CI (0.649-0.791, P < 0.001, cut-off value 912.97) and NLR values under the receiver operating characteristic curve (0.604,5% CI (0.519-0.689), P < 0.01, cut-off value 1.461), and SII values had high discrimination ability. Both SII and NLR had high diagnostic and predictive value for stroke severity, and SII was better than NLR.
The higher SII and NLR, the more severity in LAA stroke patients. SII and NLR are independent risk factors for LAA stroke, and they can also effectively predict stroke severity; moreover, SII has a higher diagnostic efficacy than NLR. However, multicenter studies with large sample size are still needed to confirm this conclusion.
全身免疫炎症指数（SII）和中性粒细胞与淋巴细胞比值（NLR）是基于中性粒细胞、血小板和淋巴细胞计数的新型炎症标志物。动脉粥样硬化是一种慢性炎症性血管疾病。本研究旨在验证全身免疫炎症指数（SII）和中性粒细胞与淋巴细胞比值（NLR）等临床参数对大动脉粥样硬化（LAA）性卒中患者病情严重程度的预测价值。
SII定义为血小板×（中性粒细胞计数/淋巴细胞计数），NLR定义为中性粒细胞计数/淋巴细胞计数。采用单因素逻辑回归分析LAA性卒中患者SII、NLR与美国国立卫生研究院卒中量表（NIHSS）评分之间的关联。采用多因素逻辑回归分析LAA性卒中严重程度的危险因素。绘制受试者工作特征曲线以确定SII和NLR在区分卒中疾病严重程度方面的诊断作用。
纳入283例LAA性卒中患者，中重度卒中组的SII和NLR显著高于轻度卒中组。多因素逻辑回归分析显示，SII（比值比1.051，95%置信区间[1.035 - 1.066]，P < 0.001）、NLR（比值比1.077，95%置信区间[1.032 - 1.123]，P < 0.001）与卒中严重程度显著相关。受试者工作特征曲线下的SII值（0.701，95%置信区间[0.649 - 0.791]，P < 0.001，临界值912.97）和受试者工作特征曲线下的NLR值（0.604,5%置信区间[0.519 - 0.689]，P < 0.01，临界值1.461），且SII值具有较高的鉴别能力。SII和NLR对卒中严重程度均具有较高的诊断和预测价值，且SII优于NLR。
LAA性卒中患者的SII和NLR越高，病情越严重。SII和NLR是LAA性卒中的独立危险因素，它们也能有效预测卒中严重程度；此外，SII的诊断效能高于NLR。然而，仍需要大样本量的多中心研究来证实这一结论。
