淋巴细胞与单核细胞比值在急性缺血性卒中中的预后价值：一项系统评价和荟萃分析。
Prognostic value of lymphocyte-to-monocyte ratio in acute ischemic stroke: a systematic review and meta-analysis.
作者信息
Tian Chengli, Yang Yilin, Wan Jun, Wang Ran, Zhou Ke, Li Yuanli, Guo Wenlong, Li Huijun, Zhang Yu
机构信息
Center for Evidence-Based Medicine, Affiliated Hospital of Chengdu University, Chengdu, Sichuan, China.
Department of Critical Care Medicine, Affiliated Hospital of Chengdu University, Chengdu, Sichuan, China.
出版信息
Front Neurol. 2025 May 7;16:1567112. doi: 10.3389/fneur.2025.1567112. eCollection 2025.
BACKGROUND
The findings from studies exploring the prognostic relevance of the lymphocyte-to-monocyte ratio (LMR) in individuals with acute ischemic stroke (AIS) have shown variability. We aimed to conduct a meta-analysis to determine the prognostic significance of LMR in this patient population.
METHODS
We carried out a meta-analysis utilizing information from major databases, including PubMed, Embase, and Web of Science until October 26, 2024. Effect sizes, represented as odds ratios (ORs) along with their corresponding 95% confidence intervals (CI), were synthesized employing a random-effects model in Review Manager Version 5.4. To investigate possible sources of variability, we conducted subgroup analyses. Additionally, publication bias was assessed through the use of a funnel plot. Poor functional outcome at 3 months, as indicated via a modified Rankin Scale score of ≥3, was the main outcome. A moderate to severe stroke, determined by a National Institutes of Health Stroke Scale score of ≥6, was the secondary outcome.
RESULTS
Six trials totaling 1,225 individuals were included in our analysis. In AIS patients, we discovered a significant correlation between lower LMR and poorer functional outcome at 3 months, with an OR of 0.63, 95% CI of 0.49 to 0.80, and a -value of 0.0002. Additionally, lower LMR may be associated with developing moderate to severe stroke, with an OR of 0.89 (95% CI: 0.82-0.97; = 0.008). In subgroup analyses with an LMR cutoff, a significant association was observed between lower LMR and greater functional impairment in AIS patients, with an odds ratio of 0.74 (95% CI: 0.62-0.88; = 0.0005) for LMR ≥ 3 and 0.54 (95% CI: 0.47-0.61; < 0.00001) for LMR < 3. Additionally, when country-stratified, Asian continued to have a significant correlation between worse functional outcome and lower LMR (OR 0.62, 95% CI: 0.50-0.77, < 0.0001).
CONCLUSION
This meta-analysis indicated that LMR was a prognostic factor for clinical outcomes in AIS patients.
背景
探索淋巴细胞与单核细胞比值（LMR）在急性缺血性卒中（AIS）患者中预后相关性的研究结果存在差异。我们旨在进行一项荟萃分析，以确定LMR在该患者群体中的预后意义。
方法
我们利用来自主要数据库（包括PubMed、Embase和Web of Science）的信息进行荟萃分析，截至2024年10月26日。效应量以比值比（OR）及其相应的95%置信区间（CI）表示，采用Review Manager 5.4版本中的随机效应模型进行综合分析。为了研究可能的变异来源，我们进行了亚组分析。此外，通过漏斗图评估发表偏倚。改良Rankin量表评分≥3表明3个月时功能预后不良是主要结局。美国国立卫生研究院卒中量表评分≥6确定的中度至重度卒中是次要结局。
结果
我们的分析纳入了6项试验，共1225例个体。在AIS患者中，我们发现较低的LMR与3个月时较差的功能预后之间存在显著相关性，OR为0.63，95%CI为0.49至0.80，P值为0.0002。此外，较低的LMR可能与发生中度至重度卒中有关，OR为0.89（95%CI：0.82 - 0.97；P = 0.008）。在LMR临界值的亚组分析中，观察到AIS患者中较低的LMR与更大的功能损害之间存在显著关联，LMR≥3时比值比为0.74（95%CI：0.62 - 0.88；P = 0.0005），LMR<3时比值比为0.54（95%CI：0.47 - 0.61；P < 0.00001）。此外，按国家分层时，亚洲人群中较差的功能预后与较低的LMR之间仍存在显著相关性（OR 0.62，95%CI：0.50 - 0.77，P < 0.0001）。
结论
这项荟萃分析表明，LMR是AIS患者临床结局的一个预后因素。
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