摘要
目的中性粒细胞与淋巴细胞比值(NLR)是亚临床炎症的可靠标志物。目前超早期(发病≤6小时)脑梗死患者中NLR与神经功能缺损严重程度的关系仍不明确。本研究旨在探讨该阶段NLR与美国国立卫生研究院卒中量表(NIHSS)评分的相关性,为早期病情评估提供依据。方法采用回顾性研究方法,纳入2021年1月至2023年12月某医院神经内二科收治的发病≤6小时的脑梗死患者。收集患者基线资料、入院NIHSS评分及实验室数据(中性粒细胞与淋巴细胞计数),通过单变量分析、多变量有序logistic回归及Spearman相关性分析,评估NLR与NIHSS评分的关联。结果共纳入219例患者。按NIHSS评分分组:轻度组(NIHSS评分≤5分,125例,57.1%),NLR中位数(四分位数间距)为2.64(1.96,3.57);中度组(6分≤NIHSS评分<15分,65例,29.7%),NLR中位数(四分位数间距)为3.42(2.39,5.48),与轻度组比较差异有统计学意义(P=0.002);重度组(NIHSS评分≥15分,29例,13.2%),NLR中位数(四分位数间距)为5.62(2.51,8.41),与轻度组比较差异有统计学意义(P<0.001)。多因素分析显示,高NLR(OR=1.173,95%CI:1.064~1.293,P=0.001)和大面积脑梗死是重型卒中的独立影响因素。Spearman相关性分析证实NLR与NIHSS评分呈正相关(r=0.298,P<0.001)。结论脑梗死超早期NLR与NIHSS评分呈显著正相关,提示NLR可作为评估卒中严重程度的潜在生物标志物。
Objective Neutrophil to lymphocyte ratio(NLR)is a reliable marker of subclinical inflammation.However,relationship between NLR and the severity of neurological deficits in patients with ultra-early cerebral infarction(onset≤6 hours)remained unclear.This study aimed to explore correlation between NLR and the National Institutes of Health Stroke Scale(NIHSS)score at this stage,so as to provide a basis for early assessment of disease severity.Methods A retrospective study was conducted,patients with cerebral infarction who were admitted to the Neurology DepartmentⅡof a hospital from January 2021 to December 2023 and had onset time of≤6 hours were included.Baseline data of patients,admission NIHSS scores,and laboratory data(neutrophil and lymphocyte counts)were collected,and correlation between NLR and NIHSS scores were evaluated through univariate analysis,multivariate ordered logistic regression,and Spearman correlation analysis.Results A total of 219 patients were included.They were divided into groups according to NIHSS scores:mild group(NIHSS score≤5,125 cases,57.1%),with a median NLR(interquartile range)of 2.64(1.96,3.57);moderate group(6≤NIHSS score<15,65 cases,29.7%),with a median NLR(interquartile range)of 3.42(2.39,5.48),and difference was statistically significant compared with that of the mild group(P=0.002);severe group(NIHSS score≥15,29 cases,13.2%),with a median NLR(interquartile range)of 5.62(2.51,8.41),and difference was statistically significant compared with that of the mild group(P<0.001).Multivariate analysis revealed that high NLR(OR=1.173,95%CI:1.064–1.293,P=0.001)and large-territory cerebral infarction were independent predictors of severe stroke.Spearman correlation analysis further confirmed a positive correlation between NLR and NIHSS score(r=0.298,P<0.001).Conclusion NLR in the ultra-early stage of cerebral infarction is significantly positively correlated with NIHSS scores,suggesting that NLR can serve as a potential biomarker for assessing the severity of stroke.
作者
李祉萱
赵俊杰
LI Zhixuan;ZHAO Junjie(Electromyography Room,Handan Central Hospital,Handan 056000,Hebei,China;Neurology DepartmentⅡ,Handan First Hospital,Handan 056000,Hebei,China)
出处
《右江医学》
2025年第8期693-699,共7页
Chinese Youjiang Medical Journal
基金
邯郸市科学技术研究与发展计划项目(23422083214)。
