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The association of neutrophil-lymphocyte ratio and lymphocyte-monocyte ratio with 3-month clinical outcome after mechanical thrombectomy following stroke
Journal of Neuroinflammation ( IF 9.3 ) Pub Date : 2020-02-18 , DOI: 10.1186/s12974-020-01739-y
Danielle Lux , Vafa Alakbarzade , Luke Bridge , Camilla N. Clark , Brian Clarke , Liqun Zhang , Usman Khan , Anthony C. Pereira

Neutrophil-lymphocyte ratio (NLR) and lymphocyte-monocyte ratio (LMR) are associated with clinical outcomes in malignancy, cardiovascular disease and stroke. Here we investigate their association with outcome after acute ischaemic stroke treated by mechanical thrombectomy (MT). Patients were selected using audit data for MT for acute anterior circulation ischaemic stroke at a UK centre from May 2016–July 2017. Clinical and laboratory data including neutrophil, lymphocyte and monocyte count tested before and 24 h after MT were collected. Poor functional outcome was defined as modified Rankin Scale (mRS) of 3–6 at 3 months. Multivariable logistic regression analyses were performed to explore the relationship of NLR and LMR with functional outcome. One hundred twenty-one patients (mean age 66.4 ± 16.7, 52% female) were included. Higher NLR (adjusted OR 0.022, 95% CI, 0.009–0.34, p = 0.001) and lower LMR (adjusted OR − 0.093, 95% CI (− 0.175)−(− 0.012), p = 0.025) at 24-h post-MT were significantly associated with poorer functional outcome when controlling for age, baseline NIHSS score, infarct size, presence of good collateral supply, recanalisation and symptomatic intracranial haemorrhage on multivariate logistic regression. Admission NLR or LMR were not significant predictors of mRS at 3 months. The optimal cut-off values of NLR and LMR at 24-h post-MT that best discriminated poor outcome were 5.5 (80% sensitivity and 60% specificity) and 2.0 (80% sensitivity and 50% specificity), respectively on receiver operating characteristic curve analysis. NLR and LMR tested at 24 h after ictus or intervention may predict 3-month functional outcome.

中文翻译:

脑卒中后机械血栓切除术后中性粒细胞-淋巴细胞比和淋巴细胞-单核细胞比与3个月临床结局的关系

中性粒细胞-淋巴细胞比(NLR)和淋巴细胞-单核细胞比(LMR)与恶性,心血管疾病和中风的临床结局相关。在这里,我们调查了通过机械血栓切除术(MT)治疗的急性缺血性中风后它们与预后的关系。使用2016年5月至2017年7月在英国中心的急性前循环缺血性卒中的MT审核数据选择患者。收集MT之前和之后24小时测试的临床和实验室数据,包括中性粒细胞,淋巴细胞和单核细胞计数。功能不良者定义为3个月时改良的Rankin量表(mRS)为3–6。进行多变量logistic回归分析以探讨NLR和LMR与功能结局的关系。其中包括一百二十一例患者(平均年龄66.4±16.7,女性52%)。术后24小时后的NLR较高(调整后的OR为0.022,95%CI,0.009-0.34,p = 0.001)和较低的LMR(调整后的OR-0.093,95%CI(-0.175)-(-0.012),p = 0.025)当控制年龄,基线NIHSS评分,梗塞面积,是否存在良好的侧支供血,再通气和有症状的颅内出血(多因素logistic回归)时,-MT与较差的功能预后显着相关。入院时NLR或LMR不是3个月时mRS的重要预测指标。能够最好地区分不良结果的MT后24小时NLR和LMR的最佳截止值分别为5.5(灵敏度80%和特异性60%)和2.0(灵敏度80%和特异性50%)2.0。曲线分析。于发作或干预后24小时进行NLR和LMR测试可预测3个月的功能预后。p = 0.001)和较低的LMR(校正后的OR-0.093,95%CI(-0.175)-(-0.012),p = 0.025)在控制年龄,基线时的功能预后较差与显着相关NIHSS评分,梗塞面积,良好的侧支供血,再通气和有症状的颅内出血(基于多因素logistic回归)。入院时NLR或LMR不是3个月时mRS的重要预测指标。能够最好地区分不良结果的MT后24小时NLR和LMR的最佳截止值分别为5.5(灵敏度80%和特异性60%)和2.0(灵敏度80%和特异性50%)2.0。曲线分析。于发作或干预后24小时进行NLR和LMR测试可预测3个月的功能预后。p = 0.001)和较低的LMR(校正后的OR-0.093,95%CI(-0.175)-(-0.012),p = 0.025)在控制年龄,基线时的功能预后较差与显着相关NIHSS评分,梗塞面积,良好的侧支供血,再通气和有症状的颅内出血(基于多因素logistic回归)。入院时NLR或LMR不是3个月时mRS的重要预测指标。能够最好地区分不良结果的MT后24小时NLR和LMR的最佳截止值分别为5.5(灵敏度80%和特异性60%)和2.0(灵敏度80%和特异性50%)2.0。曲线分析。于发作或干预后24小时进行NLR和LMR测试可预测3个月的功能预后。025)在控制年龄,基线NIHSS评分,梗塞面积,良好的侧支供血,再通气和有症状的颅内出血(多因素logistic回归)时,MT后24小时与功能转归较差显着相关。入院时NLR或LMR不是3个月时mRS的重要预测指标。能够最好地区分不良结果的MT后24小时NLR和LMR的最佳截止值分别为5.5(灵敏度80%和特异性60%)和2.0(灵敏度80%和特异性50%)2.0。曲线分析。于发作或干预后24小时进行NLR和LMR测试可预测3个月的功能预后。025)在控制年龄,基线NIHSS评分,梗塞面积,良好的侧支供血,再通气和有症状的颅内出血(多因素logistic回归)时,MT后24小时与功能转归较差显着相关。入院时NLR或LMR不是3个月时mRS的重要预测指标。能够最好地区分不良结果的MT后24小时NLR和LMR的最佳截止值分别为5.5(灵敏度80%和特异性60%)和2.0(灵敏度80%和特异性50%)2.0。曲线分析。于发作或干预后24小时进行NLR和LMR测试可预测3个月的功能预后。多因素logistic回归分析显示,有良好的附带供应,再通气和有症状的颅内出血。入院时NLR或LMR不是3个月时mRS的重要预测指标。能够最好地区分不良结果的MT后24小时NLR和LMR的最佳截止值分别为5.5(灵敏度80%和特异性60%)和2.0(灵敏度80%和特异性50%)2.0。曲线分析。于发作或干预后24小时进行NLR和LMR测试可预测3个月的功能预后。多因素logistic回归分析显示,有良好的附带供应,再通气和有症状的颅内出血。入院时NLR或LMR不是3个月时mRS的重要预测指标。能够最好地区分不良结果的MT后24小时NLR和LMR的最佳截止值分别为5.5(灵敏度80%和特异性60%)和2.0(灵敏度80%和特异性50%)2.0。曲线分析。于发作或干预后24小时进行NLR和LMR测试可预测3个月的功能预后。接收器工作特性曲线分析分别为5(灵敏度80%和60%特异性)和2.0(灵敏度80%和50%特异性)。于发作或干预后24小时进行NLR和LMR测试可预测3个月的功能预后。接收器工作特性曲线分析分别为5(灵敏度80%和60%特异性)和2.0(灵敏度80%和50%特异性)。于发作或干预后24小时进行NLR和LMR测试可预测3个月的功能预后。
更新日期:2020-02-18
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