Objectives

Inflammation is associated with the occurrence and prognosis of ischemic stroke. The aim of this study was to evaluate the association between inflammatory biomarkers and the short-term clinical outcomes of acute ischemic stroke (AIS) patients after intravenous thrombolysis (IVT).

Materials and Methods

A total of 208 AIS patients treated with IVT were enrolled in this retrospective study. Blood tests of inflammatory biomarkers, including the leukocyte count, neutrophil count, lymphocyte count, neutrophil-to-lymphocyte ratio and high-sensitivity C-reactive protein level, were conducted within 24 h after IVT. The primary outcome was decent functional recovery (DFR) [modified Rankin Scale score (mRS) of 0–2] at 3 months. The secondary outcomes included symptomatic intracranial hemorrhage and 3-month mortality. A multivariate analysis was performed to evaluate the associations between inflammatory biomarkers and 3-month clinical outcomes.

Results

At 3 months follow-up, 113 (62.2%) patients achieved DFR. As compared to patients with DFR, patients without DFR had higher leukocyte counts (8.5 ± 2.4 × 10⁹/L versus 6.9 ± 1.7 × 10⁹/L, P=0.000), neutrophil counts (6.1 ± 2.3 × 10⁹/L versus 4.6±1.7 × 10⁹/L, P=0.000) and neutrophil-to-lymphocyte ratio (4.6 ± 2.4 versus 3.3 ± 1.9, P=0.000). After adjusting for the stroke subtype, severity of stroke, and medical history, the leukocyte count and neutrophil count remained significantly correlated with non-DFR (adjusted odds ratio [OR] 1.488; 95% confidence interval [CI], 1.247–1.776; P=0.000 and adjusted OR 1.522; 95% CI, 1.269–1.826; P=0.000, respectively).

Conclusions

This study demonstrates that increased levels of inflammatory biomarkers are independently associated with poor outcomes at 3 months in AIS patients treated with IVT.

中文翻译：

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炎症标志物水平升高可预测静脉溶栓后急性缺血性卒中患者的不良结果

目标

炎症与缺血性中风的发生和预后有关。本研究的目的是评估静脉溶栓（IVT）后急性缺血性卒中（AIS）患者的炎症生物标志物与短期临床结果之间的关联。

材料和方法

这项回顾性研究共纳入208名接受IVT治疗的AIS患者。在IVT后24小时内进行了包括白细胞计数，嗜中性粒细胞计数，淋巴细胞计数，嗜中性粒细胞与淋巴细胞之比以及高敏C反应蛋白水平在内的炎症生物标志物的血液测试。主要结局为3个月时体面的功能恢复（DFR）[改良的Rankin量表评分（mRS）为0-2]。次要结果包括有症状的颅内出血和3个月的死亡率。进行多变量分析以评估炎症生物标志物与3个月临床结果之间的关联。

结果

在3个月的随访中，有113名（62.2％）患者达到了DFR。与DFR患者相比，无DFR患者的白细胞计数更高（8.5±2.4×10 ⁹ / L对6.9±1.7×10 ⁹ / L，P = 0.000），嗜中性粒细胞计数较高（6.1±2.3×10 ⁹ / L对4.6±1.7×10 ⁹ / L，P = 0.000）和中性粒细胞与淋巴细胞的比率（4.6±2.4对3.3±1.9，P = 0.000）。调整卒中亚型，卒中严重程度和病史后，白细胞计数和中性粒细胞计数仍与非DFR显着相关（校正比值比[OR] 1.488； 95％置信区间[CI]，1.247–1.776；P = 0.000并调整为OR 1.522； 95％CI为1.269–1.826；P分别为0.000）。

结论

这项研究表明，IVT治疗的AIS患者在3个月时，炎症生物标志物水平的升高与不良预后独立相关。