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外周血炎症标志物与急性缺血性脑卒中的关系
王丽君,张萍,呼延梅华,杨洁,沈红健,沈芳,陈蕾,吴雄枫,刑鹏飞,姜一,张敏敏,朱宣,袁绘,张永巍*,杨鹏飞,刘建民
0
(海军军医大学(第二军医大学)第一附属医院脑血管病中心, 上海 200433
*通信作者)
摘要:
目的 探讨外周血炎症标志物与急性缺血性脑卒中(AIS)的关系。方法 选择2022年8月至12月海军军医大学(第二军医大学)第一附属医院脑血管病中心收治的80例AIS患者为研究对象,根据美国国立卫生研究院卒中量表(NIHSS)评分,将所有患者分为轻度脑卒中组(NIHSS评分<4分,n=50)和中重度脑卒中组(NIHSS评分≥4分,n=30);根据90 d改良Rankin量表(mRS)评分,将所有患者分为预后良好组(mRS评分为0~2分,n=74)和预后不良组(mRS评分为3~6分,n=6)。收集并比较各组患者的基本临床资料、外周血炎症指标[单核细胞与淋巴细胞比值(MLR)、中性粒细胞与淋巴细胞比值(NLR)、血小板与淋巴细胞比值(PLR)、系统免疫炎症指数(SII)和全身炎症反应指数(SIRI)]等实验室检查结果。结果 与轻度脑卒中组相比,中重度脑卒中组有高脂血症病史的患者比例较高[43.3%(13/30)vs 18.0%(9/50),P=0.014],NLR较高[2.81(1.93,5.97)vs 2.01(1.64,3.37),P=0.028]。与预后良好组相比,预后不良组有高脂血症病史的患者比例较高[83.3%(5/6)vs 23.0%(17/74),P=0.007],但两组间MLR、NLR、PLR、SII、SIRI差异均无统计学意义(均P>0.05)。结论 中重度脑卒中AIS患者外周血炎症标志物NLR较高。
关键词:  急性缺血性脑卒中  炎症标志物  中性粒细胞与淋巴细胞比值  病情严重程度  预后
DOI:10.16781/j.CN31-2187/R.20230539
投稿时间:2023-09-25修订日期:2023-12-13
基金项目:中华国际医学交流基金会脑血管病青年创新基金(Z-2016-20-2201),中国卒中学会脑血管病全程管理项目启航基金(2023).
Relationships between peripheral blood inflammatory markers and acute ischemic stroke
WANG Lijun,ZHANG Ping,HUYAN Meihua,YANG Jie,SHEN Hongjian,SHEN Fang,CHEN Lei,WU Xiongfeng,XING Pengfei,JIANG Yi,ZHANG Minmin,ZHU Xuan,YUAN Hui,ZHANG Yongwei*,YANG Pengfei,LIU Jianmin
(Neurovascular Center, The First Affiliated Hospital of Naval Medical University (Second Military Medical University), Shanghai 200433, China
*Corresponding author)
Abstract:
Objective To explore the relationships between peripheral blood inflammatory markers and acute ischemic stroke (AIS). Methods A total of 80 AIS patients in Neurovascular Center of The First Affiliated Hospital of Naval Medical University (Second Military Medical University) from Aug. to Dec. 2022 were enrolled. According to the National Institutes of Health stroke scale (NIHSS) score, the patients were categorized into mild AIS group (NIHSS<4, n=50) or moderate-to-severe AIS group (NIHSS≥4, n=30). According to the 90-day modified Rankin scale (mRS) score, the patients were categorized into favorable outcome group (mRS 0-2, n=74) or unfavorable outcome group (mRS 3-6, n=6). The basic clinical data, peripheral blood inflammatory markers (including monocyte to lymphocyte ratio [MLR], neutrophil to lymphocyte ratio [NLR], platelet to lymphocyte ratio [PLR], systemic immune-inflammation index [SII], and systemic inflammatory response index [SIRI]), and other laboratory data of the patients in each group were collected and compared. Results Compared with the mild AIS group, the moderate-to-severe AIS group had a significantly higher proportion of hyperlipidemia history (43.3% [13/30]vs 18.0% [9/50], P=0.014) and significantly higher NLR (2.81 [1.93, 5.97] vs 2.01 [1.64, 3.37], P=0.028). Compared with the favorable outcome group, the unfavorable outcome group had a significantly higher proportion of hyperlipidemia history (83.3% [5/6] vs 23.0% [17/74], P=0.007), but there were no differences in MLR, NLR, PLR, SII, or SIRI (all P>0.05). Conclusion Moderate-to-severe AIS patients have higher NLR.
Key words:  acute ischemic stroke  inflammatory markers  neutrophil to lymphocyte ratio  severity of the disease  prognosis