缺血性中风患者淋巴细胞计数、白质高信号与脑萎缩之间的相关性。

Correlations among lymphocyte count, white matter hyperintensity and brain atrophy in patients with ischemic stroke.

作者信息

Liu Chenchen, Shi Dai, Ni Xiaoqiong, You Shoujiang, Wu Xiaofen, Zhuang Sheng, Cai Wu, Xu Liang

机构信息

Department of Radiology, Clinical Research Center of Neurological Disease, The Second Affiliated Hospital of Soochow University, Suzhou, China.

Department of Neurology, The Second Affiliated Hospital of Soochow University, Suzhou, China.

出版信息

Front Aging Neurosci. 2025 Jan 8;16:1492078. doi: 10.3389/fnagi.2024.1492078. eCollection 2024.

DOI:10.3389/fnagi.2024.1492078

PMID:39845446

原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC11751001/

Abstract

BACKGROUND

White matter hyperintensity (WMH) and brain atrophy, as imaging marker of cerebral small-vessel diseases (CSVD), have a high prevalence and strong prognostic value in stroke. We aimed to explore the association between lymphocyte count, a maker of inflammation, and WMH and brain atrophy in patients with acute ischemic stroke (AIS).

METHODS

A total of 727 AIS patients with lymphocyte count and brain magnetic resonance imaging data were enrolled. Participants were divided into four groups according to the quartiles of baseline lymphocyte counts. WMH is frequently divided into periventricular hyperintensity (PVH) and deep white matter hyperintensity (DWMH). WMH was defined as Fazekas scale score ≥ 3; PVH was defined as periventricular Fazekas scale ≥2; DWMH was defined as deep Fazekas scale ≥2. Brain atrophy was defined as global cortical atrophy score ≥ 1. Multivariable logistic regression models were used to assess the association between lymphocyte count and WMH and brain atrophy.

RESULTS

Among 727 AIS, 517 (71.1%), 442 (60.8%), 459 (63.1%), 583 (80.2%) had WMH, PVH, DWMH and brain atrophy, respectively. After adjustment for potential covariates, the highest quartiles of lymphocyte counts were significantly associated with lower risk of WMH (adjusted odds ratio [aOR] 0.57, 95% confidence intervals [CI] 0.32-0.99), PVH (aOR 0.52, 95% CI 0.31-0.87), DWMH (aOR 0.53 95% CI 0.32-0.90) as well as brain atrophy (aOR 0.46, 95% CI 0.23-0.92) compared with the lowest quartiles of lymphocyte counts, respectively. Furthermore, a notable inverse association was observed between continuous lymphocyte counts and WMH, PVH, DWMH, and brain atrophy. Additionally, we found that the inverse association between baseline lymphocyte count and WMH was significant only in individuals with mild stroke.

CONCLUSION

In patients with AIS, there was an independent and inverse association between the baseline lymphocyte count and both WMH and brain atrophy.

摘要

背景

脑白质高信号（WMH）和脑萎缩作为脑小血管病（CSVD）的影像学标志物，在卒中中具有高患病率和强预后价值。我们旨在探讨炎症标志物淋巴细胞计数与急性缺血性卒中（AIS）患者的WMH和脑萎缩之间的关联。

方法

共纳入727例有淋巴细胞计数和脑磁共振成像数据的AIS患者。参与者根据基线淋巴细胞计数的四分位数分为四组。WMH常分为脑室周围高信号（PVH）和深部脑白质高信号（DWMH）。WMH定义为 Fazekas量表评分≥3；PVH定义为脑室周围Fazekas量表≥2；DWMH定义为深部Fazekas量表≥2。脑萎缩定义为全脑皮质萎缩评分≥1。采用多变量逻辑回归模型评估淋巴细胞计数与WMH和脑萎缩之间的关联。

结果

在727例AIS患者中，分别有517例（71.1%）、442例（60.8%）、459例（63.1%）、583例（80.2%）有WMH、PVH、DWMH和脑萎缩。在对潜在协变量进行调整后，淋巴细胞计数最高四分位数与WMH（调整后的优势比[aOR]0.57，95%置信区间[CI]0.32 - 0.99）、PVH（aOR 0.52，95% CI 0.31 - 0.87）、DWMH（aOR 0.53，95% CI 0.32 - 0.90）以及脑萎缩（aOR 0.46，95% CI 0.23 - 0.92）的较低风险显著相关，与淋巴细胞计数最低四分位数相比。此外，在连续的淋巴细胞计数与WMH、PVH、DWMH和脑萎缩之间观察到显著的负相关。此外，我们发现基线淋巴细胞计数与WMH之间的负相关仅在轻度卒中个体中显著。