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烟雾病成年卒中患者外周血炎症生物标志物与不良临床结局的关联

Association of peripheral blood inflammatory biomarkers and poor clinical outcomes in adult stroke patients with moyamoya disease.

作者信息

Wu Xiaoju, Huang Rilan, Su Shanghua, Li Xiaoling, Lin Xiaozuo, Wang Pingkai, Hong Zhaoju, Zheng Ruoxi, Zeng Yinan, Huang Chaojue, Luo Man

机构信息

Department of Neurology, First Affiliated Hospital of Guangxi Medical University, Nanning 530021, China.

Department of Neurosurgery, First Affiliated Hospital of Guangxi Medical University, Nanning, Guangxi, China.

出版信息

J Stroke Cerebrovasc Dis. 2025 Aug;34(8):108351. doi: 10.1016/j.jstrokecerebrovasdis.2025.108351. Epub 2025 May 16.

Abstract

PURPOSE

Stroke is the common manifestation of moyamoya disease (MMD). The study aimed to explore the correlation between inflammatory biomarkers and the poor clinical outcomes in adult stroke patients with MMD.

PATIENTS AND METHODS

The retrospective study included adult patients with MMD who were admitted to the First Affiliated Hospital of Guangxi Medical University from June 2012 to November 2023. Functional outcomes were assessed using the modified Rankin Scale (mRS) score. We assessed the area under the curves (AUC) for platelet-to-lymphocyte ratio (PLR), neutrophil-to-lymphocyte ratio (NLR), monocyte-to-lymphocyte ratio (MLR), systemic immune-inflammation index (SII) and neutrophil-to-albumin ratio (NAR) in predicting the poor clinical outcomes.

RESULTS

Overall 201 eligible MMD patients including 29 subjects without stroke, 97 subjects with ischemic stroke and 75 subjects with hemorrhagic stroke were collected. In MMD patients with ischemic stroke, those with poor outcomes had significantly higher levels of SII and NAR. The AUCs of SII and NAR were respectively 0.667 and 0.684, while the AUC for joint application was 0.683. In MMD patients with hemorrhagic stroke, those with poor outcomes had significantly higher levels of PLR, NLR, MLR, SII, and NAR. And the AUCs were respectively 0.678, 0.727, 0.643, 0.751, 0.744, while the AUC for joint application of these inflammatory biomarkers was 0.793, higher than a single indicator.

CONCLUSION

Higher SII and NAR levels were associated with poor clinical outcomes in MMD patients with ischemic stroke. Higher PLR, NLR, MLR, SII, and NAR levels were associated with poor clinical outcomes in MMD patients with hemorrhagic stroke.

摘要

目的

中风是烟雾病(MMD)的常见表现。本研究旨在探讨炎症生物标志物与成年烟雾病中风患者不良临床结局之间的相关性。

患者与方法

这项回顾性研究纳入了2012年6月至2023年11月在广西医科大学第一附属医院住院的成年烟雾病患者。使用改良Rankin量表(mRS)评分评估功能结局。我们评估了血小板与淋巴细胞比值(PLR)、中性粒细胞与淋巴细胞比值(NLR)、单核细胞与淋巴细胞比值(MLR)、全身免疫炎症指数(SII)和中性粒细胞与白蛋白比值(NAR)预测不良临床结局的曲线下面积(AUC)。

结果

共收集了201例符合条件的烟雾病患者,包括29例无中风患者、97例缺血性中风患者和75例出血性中风患者。在缺血性中风的烟雾病患者中,结局不良者的SII和NAR水平显著更高。SII和NAR的AUC分别为0.667和0.684,联合应用时的AUC为0.683。在出血性中风的烟雾病患者中,结局不良者的PLR、NLR、MLR、SII和NAR水平显著更高。其AUC分别为0.678、0.727、0.643、0.751、0.744,这些炎症生物标志物联合应用时的AUC为0.793,高于单一指标。

结论

在缺血性中风的烟雾病患者中,较高的SII和NAR水平与不良临床结局相关。在出血性中风的烟雾病患者中,较高的PLR、NLR、MLR、SII和NAR水平与不良临床结局相关。

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