Abstract

Background

Inflammatory response plays an important role in the process of ischemic stroke. Rapid, sustained and complete reperfusion is the most important modifiable prognostic factor for a favorable clinical outcome in patients receiving endovascular treatment (EVT). The studies related to the clot contents regarding the high level of leukocyte clots that are difficult to recanalize are quite remarkable. We aimed to investigate the relationship between Neutrophil to lymphocyte ratio and recanalization at the first pass thrombectomy.

Methods

Study was conducted from February 2015 to December 2018. Patients with stroke were treated with mechanical thrombectomy. The normality of distribution of continuous variables was tested by Shapiro–Wilk test. The Mann–Whitney U test and Chi-square test was used to assess relations between variables. ROC curve analysis was performed to determine the cut-off value for NLR.

Results

There were 84 patients included the study, the mean age 62.8 ± 12.9; 61.9% (52/84) that were female; median (IQR 25–75) NIHSS 16 (14–19) treated with stent-retriever-based thrombectomy. The distribution of NLR was skewed (p value for 1-sample Kolmogorov–Smirnov test: <0.001). In terms of recanalization outcomes, the patients with NLR < 3.51 showed a significantly higher rates of successful recanalization (AUC = 0.671 ± 0.06; p = 0.005).

Conclusion

This study demonstrates that higher admission NLR values are independent predictors of unsuccessful recanalization first pass in MCA M1 occlusion of stroke patients treated with mechanical stent-retriever-based thrombectomy. Future large cohort and structural analysis of thrombi studies are needed to further explore the role of NLR as a prognostic neuroinflammatory biomarker for successful recanalization in EVT of stroke.

中文翻译：

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大脑中动脉闭塞支架取栓取栓首过再通与中性粒细胞淋巴细胞比值的关系

摘要

背景

炎症反应在缺血性卒中过程中起重要作用。快速、持续和完全再灌注是接受血管内治疗 (EVT) 患者获得良好临床结果的最重要的可改变预后因素。关于难以再通的高水平白细胞凝块的凝块含量的研究相当显着。我们的目的是研究中性粒细胞与淋巴细胞的比率与第一次血栓切除术再通之间的关系。

方法

研究于 2015 年 2 月至 2018 年 12 月进行。中风患者接受机械取栓治疗。连续变量分布的正态性通过 Shapiro-Wilk 检验进行检验。Mann-Whitney U检验和卡方检验用于评估变量之间的关系。进行 ROC 曲线分析以确定 NLR 的截止值。

结果

共有 84 名患者纳入研究，平均年龄 62.8 ± 12.9；61.9% (52/84) 是女性；中位数 (IQR 25-75) NIHSS 16 (14-19) 接受基于支架取栓器的血栓切除术。NLR 的分布是倾斜的（ 1 样本 Kolmogorov-Smirnov 检验的p值：<0.001）。在再通结果方面，NLR < 3.51 的患者显示出显着更高的再通成功率（AUC = 0.671 ± 0.06；p  = 0.005）。

结论

这项研究表明，较高的入院 NLR 值是在接受机械支架取栓器取栓治疗的中风患者的 MCA M1 闭塞中第一次再通不成功的独立预测因素。未来需要对血栓研究进行大型队列和结构分析，以进一步探索 NLR 作为预后神经炎症生物标志物在卒中 EVT 成功再通中的作用。