Hong Ye, Shi Jian-Quan, Feng Shuai, Huang Shi-Qi, Yuan Zhen-Hua, Liu Shen, Zhang Xiao-Hao, Zhou Jun-Shan, Jiang Teng, Zhao Hong-Dong, Zhang Ying-Dong
Department of Neurology, Nanjing First Hospital, Nanjing Medical University, Nanjing, Jiangsu, China.
Front Neurosci. 2025 Mar 5;19:1552949. doi: 10.3389/fnins.2025.1552949. eCollection 2025.
Amyotrophic lateral sclerosis (ALS) is a fatal and untreatable neurodegenerative disease with only 3-5 years' survival time after diagnosis. Inflammation has been proven to play important roles in ALS progression. However, the relationship between systemic inflammation markers and ALS has not been well established, especially in Chinese ALS patients. The present study aimed to assess the predictive value of systemic inflammation markers including neutrophil to lymphocyte ratio (NLR), platelet to lymphocyte ratio (PLR), lymphocyte to monocyte ratio (LMR), and systemic immune-inflammation index (SII) for Chinese amyotrophic lateral sclerosis (ALS).
Seventy-two Chinese ALS patients and 73 controls were included in this study. The rate of disease progression was calculated as the change of Revised ALS Functional Rating Scale (ALSFRS-R) score per month. Patients were classified into fast progressors if the progression rate > 1.0 point/month and slow progressors if progression rate ≤ 1.0 point/month. The value of NLR, PLR, LMR, and SII were measured based on blood cell counts. The association between systemic inflammation markers and disease progression rate was confirmed by logistic regression analysis. Kaplan-Meier curve and Cox regression models were used to evaluate factors affecting the survival outcome of ALS patients.
For Chinese ALS patients, NLR, PLR and SII were higher, LMR was lower when compared with controls. All these four markers were proved to be independent correlated with fast progression of ALS. Both Kaplan-Meier curve and Cox regression analysis indicated that higher NLR and lower LMR were associated with shorter survival time in the ALS patients.
In conclusion, the systemic inflammation markers, especially NLR and LMR might be independent markers for rapid progression and shorter survival time in Chinese ALS patients.
肌萎缩侧索硬化症（ALS）是一种致命且无法治愈的神经退行性疾病，诊断后生存期仅为3至5年。炎症已被证明在ALS进展中起重要作用。然而，全身炎症标志物与ALS之间的关系尚未完全明确，尤其是在中国ALS患者中。本研究旨在评估包括中性粒细胞与淋巴细胞比值（NLR）、血小板与淋巴细胞比值（PLR）、淋巴细胞与单核细胞比值（LMR）以及全身免疫炎症指数（SII）在内的全身炎症标志物对中国肌萎缩侧索硬化症（ALS）的预测价值。
本研究纳入了72例中国ALS患者和73例对照。疾病进展率计算为每月修订的ALS功能评定量表（ALSFRS-R）评分的变化。如果进展率>1.0分/月，则患者被分类为快速进展者；如果进展率≤1.0分/月，则为缓慢进展者。基于血细胞计数测量NLR、PLR、LMR和SII的值。通过逻辑回归分析确定全身炎症标志物与疾病进展率之间的关联。采用Kaplan-Meier曲线和Cox回归模型评估影响ALS患者生存结局的因素。
对于中国ALS患者，与对照组相比，NLR、PLR和SII更高，LMR更低。所有这四种标志物均被证明与ALS的快速进展独立相关。Kaplan-Meier曲线和Cox回归分析均表明，较高的NLR和较低的LMR与ALS患者较短的生存时间相关。
总之，全身炎症标志物，尤其是NLR和LMR可能是中国ALS患者快速进展和较短生存时间的独立标志物。
