外周血淋巴细胞/单核细胞比值与急性脑梗塞的预后关系
|
摘要
目的探讨淋巴细胞/单核细胞比值(LMR)等炎症指标与脑梗塞发生和预后的关系。方法回顾性分析2015年1月-12月本院的150例脑梗塞患者为缺血性脑梗塞组,另收集同期健康体检者150例为健康对照组,评估2组LMR等炎症指标与脑梗塞发生以及预后的关系。结果 LMR等炎症指标在缺血性脑梗塞组和健康对照组中的分布差异有统计学意义(P<0.01)。但多因素分析以及受试者工作特征(ROC)曲线分析表明仅有中性粒细胞绝对值>4.23、单核细胞绝对值>0.37、淋巴细胞绝对值<1.32、PLR>106为脑梗塞的危险因素(P<0.05)。相关性分析表明,中性粒细胞绝对值、中性粒细胞/淋巴细胞比值(NLR)、血小板/淋巴细胞比值(PLR)、淋巴细胞绝对值、LMR均与入院时、出院时、出院后90 d时的mRS评分相关(P<0.05),多因素分析表明仅有LMR与出院时、出院90 d时mRS评分有关(P<0.05)。结论 LMR与脑梗塞患者的预后相关;淋巴细胞、单核细胞、中性粒细胞绝对值、PLR与脑梗塞的危险性相关。
Objective To investigate the relationship between inflammatory markers such as lymphocyte-monocyte ratio and presence and prognosis of acute ischemic stroke( AIS). Methods We retrospectively reviewed the clinical data of 150 patients with AIS as well as 150 healthy controls to evaluate the association of inflammatory markers such as lymphocyte-monocyte ratio( LMR) with the presence of AIS and prognosis. Results The distribution difference of inflammatory markers such as LMR between AIS group and control group had statistical significance( P < 0. 01). While multivariate logistic regression analysis and receiver operating characteristic curve( ROC) analysis suggested that only absolute neutrocyte count > 4. 23,absolute monocyte count > 0. 37,absolute lymphocyte count > 132 and platelet-lymphocyte ratio( PLR) > 106 were risk factors for the presence of AIS( P < 0. 05). Although correlation analysis indicated that absolute neutrocyte,lymphocyte count,neutrocyte-lymphocyte ratio( NLR),PLR and LMR were related to m RS performed at patients admitted to hospital,before discharge and 90 d after discharged( P < 0. 05),only LMR was associated with m RS performed at patients before discharge and 90 d after discharged suggested by multivariate logistic regression analysis( P < 0. 05). Conclusion LMR is related to the prognosis of patients with AIS. Furthermore,the absolute neutrocyte,monocyte,lymphocyte count and PLR are related to the risk of AIS.
Objective To investigate the relationship between inflammatory markers such as lymphocyte-monocyte ratio and presence and prognosis of acute ischemic stroke( AIS). Methods We retrospectively reviewed the clinical data of 150 patients with AIS as well as 150 healthy controls to evaluate the association of inflammatory markers such as lymphocyte-monocyte ratio( LMR) with the presence of AIS and prognosis. Results The distribution difference of inflammatory markers such as LMR between AIS group and control group had statistical significance( P < 0. 01). While multivariate logistic regression analysis and receiver operating characteristic curve( ROC) analysis suggested that only absolute neutrocyte count > 4. 23,absolute monocyte count > 0. 37,absolute lymphocyte count > 132 and platelet-lymphocyte ratio( PLR) > 106 were risk factors for the presence of AIS( P < 0. 05). Although correlation analysis indicated that absolute neutrocyte,lymphocyte count,neutrocyte-lymphocyte ratio( NLR),PLR and LMR were related to m RS performed at patients admitted to hospital,before discharge and 90 d after discharged( P < 0. 05),only LMR was associated with m RS performed at patients before discharge and 90 d after discharged suggested by multivariate logistic regression analysis( P < 0. 05). Conclusion LMR is related to the prognosis of patients with AIS. Furthermore,the absolute neutrocyte,monocyte,lymphocyte count and PLR are related to the risk of AIS.
引文
[1]Mantovani A,Allavena P,Sica A,et al.Cancer-related inflammation[J].Nature,2008,454(7203):436-444.
[2]Bhat T,Teli S,Rijal J,et al.Neutrophil to lymphocyte ratio and cardiovascular diseases:a review[J].Expert Rev Cardiovasc Ther,2013,11(1):55-59.
[3]Emsley HC,Smith CJ,Tyrrell PJ,et al.Inflammation in acute ischemic stroke and its relevance to stroke critical care[J].Neurocrit Care,2008,9(1):125-138.
[4]Vangilder RL,Davidov DM,Stinehart KR,et al.C-reactive protein and long-term ischemic stroke prognosis[J].J Clin Neurosci,2014,21(4):547-553.
[5]高巍,韩志君,杜永胜,等.中性粒细胞/淋巴细胞比值与急性缺血性脑梗塞预后的关系[J].临床与病理杂志,2014,34(5):509-513.
[6]邱毅.中老年急性脑梗死患者心肺功能5项检测的临床意义[J].中国卫生检验杂志,2016,26(8):1138-1140.
[7]罗招凡,劳伟思,梁伟南,等.血清同型半胱氨酸和SOD水平与急性脑梗死的相关性研究[J].中国卫生检验杂志,2011,21(10):2463-2464.
[8]李红娟,李庆.脑梗死患者相关危险因素分析[J].中国卫生检验杂志,2013,23(2):487-488.
[9]Hutterer GC,Stoeckigt C,Stojakovic T,et al.Low preoperative lymphocyte-monocyte ratio(LMR)represents a potentially poor prognostic factor in nonmetastatic clear cell renal cell carcinoma[J].Urol Oncol,2014,32(7):1041-1048.
[10]Barone FC,Feuerstein GZ.Inflammatory mediators and stroke:New opportunities for novel therapeutics[J].J Cereb Blood Flow Metab,1999,19(8):819-834.
[11]Ionita CC,Siddiqui AH,Levy EI,et al.Acute ischemic stroke and infections[J].J Stroke Cerebrovasc Dis,2011,20(1):1-9.
[12]Kim JY,Kawabori M,Yenari MA.Innate inflammatory responses in stroke:mechanisms and potential therapeutic targets[J].Curr Med Chem,2014,21(18):2076-2097.
[13]Tokgoz S,Kayrak M,Akpinar Z,et al.Neutrophil lymphocyte ratio as a predictor of stroke[J].J Stroke Cerebrovasc Dis,2013,22(7):1169-1174.
[14]Kim J,Song TJ,Park JH,et al.Different prognostic value of white blood cell subtypes in patients with acute cerebral infarction[J].Atherosclerosis,2012,222(2):464-467.
[15]Moskowitz MA,Lo EH,Iadecola C.The science of stroke:mechanisms in search of treatments[J].Neuron,2010,67(2):181-198.
[2]Bhat T,Teli S,Rijal J,et al.Neutrophil to lymphocyte ratio and cardiovascular diseases:a review[J].Expert Rev Cardiovasc Ther,2013,11(1):55-59.
[3]Emsley HC,Smith CJ,Tyrrell PJ,et al.Inflammation in acute ischemic stroke and its relevance to stroke critical care[J].Neurocrit Care,2008,9(1):125-138.
[4]Vangilder RL,Davidov DM,Stinehart KR,et al.C-reactive protein and long-term ischemic stroke prognosis[J].J Clin Neurosci,2014,21(4):547-553.
[5]高巍,韩志君,杜永胜,等.中性粒细胞/淋巴细胞比值与急性缺血性脑梗塞预后的关系[J].临床与病理杂志,2014,34(5):509-513.
[6]邱毅.中老年急性脑梗死患者心肺功能5项检测的临床意义[J].中国卫生检验杂志,2016,26(8):1138-1140.
[7]罗招凡,劳伟思,梁伟南,等.血清同型半胱氨酸和SOD水平与急性脑梗死的相关性研究[J].中国卫生检验杂志,2011,21(10):2463-2464.
[8]李红娟,李庆.脑梗死患者相关危险因素分析[J].中国卫生检验杂志,2013,23(2):487-488.
[9]Hutterer GC,Stoeckigt C,Stojakovic T,et al.Low preoperative lymphocyte-monocyte ratio(LMR)represents a potentially poor prognostic factor in nonmetastatic clear cell renal cell carcinoma[J].Urol Oncol,2014,32(7):1041-1048.
[10]Barone FC,Feuerstein GZ.Inflammatory mediators and stroke:New opportunities for novel therapeutics[J].J Cereb Blood Flow Metab,1999,19(8):819-834.
[11]Ionita CC,Siddiqui AH,Levy EI,et al.Acute ischemic stroke and infections[J].J Stroke Cerebrovasc Dis,2011,20(1):1-9.
[12]Kim JY,Kawabori M,Yenari MA.Innate inflammatory responses in stroke:mechanisms and potential therapeutic targets[J].Curr Med Chem,2014,21(18):2076-2097.
[13]Tokgoz S,Kayrak M,Akpinar Z,et al.Neutrophil lymphocyte ratio as a predictor of stroke[J].J Stroke Cerebrovasc Dis,2013,22(7):1169-1174.
[14]Kim J,Song TJ,Park JH,et al.Different prognostic value of white blood cell subtypes in patients with acute cerebral infarction[J].Atherosclerosis,2012,222(2):464-467.
[15]Moskowitz MA,Lo EH,Iadecola C.The science of stroke:mechanisms in search of treatments[J].Neuron,2010,67(2):181-198.