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Association of inflammatory and platelet volume markers with clinical outcome in patients with anterior circulation ischaemic stroke after endovascular thrombectomy
Neurological Research ( IF 1.9 ) Pub Date : 2021-01-05 , DOI: 10.1080/01616412.2020.1870359
Zhongyun Chen 1 , Yanbo He 2 , Yingying Su 1 , Yijia Sun 1 , Yingbo Zhang 3 , Hongbo Chen 4
Affiliation  

ABSTRACT

Background: To determine the correlation of inflammatory and platelet volume indices with the severity of stroke and 3-month clinical outcomes in patients with acute ischemic stroke (AIS) after endovascular thrombectomy (EVT).

Methods: A retrospective analysis was conducted for AIS patients who underwent EVT at our hospital from 2015 to 2019. Inflammatory factors, including white blood count, neutrophil count, lymphocyte count, neutrophil to lymphocyte ratio (NLR), high-sensitivity C-reactive protein (hs-CRP), procalcitonin (PCT) and interleukin-6 (IL-6), and platelet volume indices, including platelet count (PC), mean platelet volume (MPV), platelet distribution width (PDW) and MPV/PC levels were assessed. Results were analyzed between patients with favorable and unfavorable outcomes at 3 months post-EVT.

Results: A total of 257 AIS patients were included in the study. There were 86 (33.5%) patients with favorable functional outcomes at 3 months. Compared to patients with favorable outcomes, those with poor outcomes have lower lymphocyte count, higher neutrophil count and NLR levels. There were no differences in hs-CRP,PCT and IL-6 between the two groups. The correlation analysis showed that the increase in MPV, PDW, and MPV/PC was related to the high level of the NIHSS score at admission. Multivariate logistic regression analysis showed that higher NLR levels are an independent risk factor for unfavorable outcomes at 3 months (OR = 1.141; 95% CI 1.061 to 1.227, P = 0.000).

Conclusions: MPV, PDW, and MPV/PC are associated with stroke severity. Higher NLR levels upon admission may predict unfavorable functional outcomes in patients with AIS after undergoing EVT.Abbreviations ACA: anterior cerebral artery; AIS: acute ischemic stroke; ASPECTS: alberta stroke program early CT score; BMI: body mass index; DBP: diastolic blood pressure; END: early neurological deterioration; EVT: endovascular thrombectomy; hs-CRP: high-sensitivity C-reactive protein; HT: hemorrhagic transformation; ICA: internal carotid artery; IL-6: interleukin-6; IS: ischemic progression; LAA: Large-Artery Atherosclerosis; MCA: middle cerebral artery; MPV: mean platelet volume; mTICI: modified thrombolysis in cerebral infarction; NIHSS: National Institute of Health stroke scale; NLR: neutrophil to lymphocyte ratio; OTP: onset-to-puncture; PC: platelet count; PCT: procalcitonin; PDW: platelet distribution width; SBP: systolic blood pressure; sICH: symptomatic intracerebral hemorrhageWBC: white blood cell.



中文翻译:

血管内血栓切除术后前循环缺血性卒中患者炎症和血小板体积标志物与临床结局的相关性

摘要

背景:旨在确定血管内血栓切除术(EVT)后急性缺血性卒中(AIS)患者的炎症和血小板体积指数与卒中严重程度和 3 个月临床结局的相关性。

方法:回顾性分析2015-2019年在我院接受EVT的AIS患者炎症因素,包括白细胞计数、中性粒细胞计数、淋巴细胞计数、中性粒细胞/淋巴细胞比(NLR)、高敏C反应蛋白(hs-CRP)、降钙素原 (PCT) 和白介素 6 (IL-6) 以及血小板体积指数,包括血小板计数 (PC)、平均血小板体积 (MPV)、血小板分布宽度 (PDW) 和 MPV/PC 水平被评估。结果在 EVT 后 3 个月时对具有有利和不利结果的患者进行了分析。

结果:本研究共包括 257 名 AIS 患者。有 86 名 (33.5%) 患者在 3 个月时具有良好的功能结果。与预后良好的患者相比,预后不良的患者淋巴细胞计数较低,中性粒细胞计数和 NLR 水平较高。两组间hs-CRP、PCT和IL-6无差异。相关性分析表明,MPV、PDW、MPV/PC的增加与入院时NIHSS评分高水平有关。多变量逻辑回归分析显示,较高的 NLR 水平是 3 个月时不良结果的独立危险因素(OR = 1.141;95% CI 1.061 至 1.227,P  = 0.000)。

结论:MPV、PDW 和 MPV/PC 与卒中严重程度相关。入院时较高的 NLR 水平可能预示着 AIS 患者接受 EVT 后的不良功能结果。缩写ACA:大脑前动脉;AIS:急性缺血性中风;ASPECTS:艾伯塔卒中计划早期CT评分;BMI:体重指数;DBP:舒张压;END:早期神经功能恶化;EVT:血管内血栓切除术;hs-CRP:高敏C反应蛋白;HT:出血性转化;ICA:颈内动脉;IL-6:白介素-6;IS:缺血进展;LAA:大动脉粥样硬化;MCA:大脑中动脉;MPV:平均血小板体积;mTICI:改良的脑梗塞溶栓;NIHSS:美国国立卫生研究院卒中量表;NLR:中性粒细胞与淋巴细胞的比率;OTP:开始到穿刺;PC:血小板计数;PCT:降钙素原;PDW:血小板分布宽度;SBP:收缩压;sICH:症状性脑出血 WBC:白细胞。

更新日期:2021-01-05
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