Diagnostic Value of Neutrophil-to-Lymphocyte Ratio for Poor Prognosis of Intravenous Thrombolysis in Acute Cerebral Infarction: A Systematic Review and Meta-Analysis

IF 4.5 2区医学 Q1 MEDICINE, GENERAL & INTERNAL

American Journal of Preventive Medicine Pub Date : 2025-07-30 DOI:10.1016/j.amepre.2025.107911

Mujia Shi , Ziqian Wang , Xinyu Ren , Rui Liu , Bonan Hou

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Abstract

Introduction

The aim of this study was to assess the diagnostic value of neutrophil-to-lymphocyte ratio (NLR) in predicting poor prognosis in cerebral infarction.

Method

We searched PubMed, Web of Science, Embase, CNKI, Wanfang database, China Biomedical Literature Database (SinoMed), VIP, and the Cochrane Library to systematically retrieve relevant literature. Diagnostic value was assessed using forest plots, sensitivity, specificity, positive likelihood ratios, negative likelihood ratios and diagnostic odds ratios, and publication bias was assessed using funnel plots.

Results

A total of 55 studies with 10,958 cases were included. Meta-analysis showed: Pre-thrombolysis NLR predicted poor prognosis with 0.70 sensitivity and 0.75 specificity. Post-thrombolysis NLR had 0.71 sensitivity and 0.72 specificity. Subgroup analysis showed no heterogeneity in pre-thrombolysis NLR for poor functional outcomes (ADL) and post-thrombolysis NLR for mortality and stroke-associated pneumonia (SAP). Sensitivity analysis confirmed result stability. Deeks’ funnel plot suggested no publication bias (P<0.05).

Discussion

NLR has moderate diagnostic value in predicting the prognosis of AIS, and can provide reference for treatment decision-making and rehabilitation management of AIS. However, due to the limitations of the quantity, quality and sample size of the included studies, the above conclusions still need to be confirmed by more large-sample, multi-center prospective studies.

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中性粒细胞与淋巴细胞比值对急性脑梗死静脉溶栓不良预后的诊断价值：一项系统综述和meta分析

摘要本研究旨在探讨中性粒细胞与淋巴细胞比值（NLR）对脑梗死预后不良的诊断价值。方法检索PubMed、Web of Science、Embase、中国知网（CNKI）、万方数据库、中国生物医学文献数据库（SinoMed）、维普（VIP）和Cochrane图书馆，系统检索相关文献。使用森林图、敏感性、特异性、正似然比、负似然比和诊断优势比评估诊断价值，并使用漏斗图评估发表偏倚。结果共纳入55项研究，10958例病例。meta分析显示：溶栓前NLR预测不良预后的敏感性为0.70，特异性为0.75。溶栓后NLR的敏感性为0.71，特异性为0.72。亚组分析显示，溶栓前的不良功能预后NLR （ADL）和溶栓后的死亡率和卒中相关肺炎NLR （SAP）无异质性。敏感性分析证实了结果的稳定性。Deeks漏斗图显示无发表偏倚（P<0.05）。nlr在预测AIS预后方面具有中等诊断价值，可为AIS的治疗决策和康复管理提供参考。然而，由于纳入研究的数量、质量和样本量的限制，上述结论仍需要更多的大样本、多中心前瞻性研究来证实。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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来源期刊

American Journal of Preventive Medicine 医学-公共卫生、环境卫生与职业卫生

CiteScore

8.60

自引率

1.80%

发文量

395

审稿时长

32 days

期刊介绍： The American Journal of Preventive Medicine is the official journal of the American College of Preventive Medicine and the Association for Prevention Teaching and Research. It publishes articles in the areas of prevention research, teaching, practice and policy. Original research is published on interventions aimed at the prevention of chronic and acute disease and the promotion of individual and community health. Of particular emphasis are papers that address the primary and secondary prevention of important clinical, behavioral and public health issues such as injury and violence, infectious disease, women''s health, smoking, sedentary behaviors and physical activity, nutrition, diabetes, obesity, and substance use disorders. Papers also address educational initiatives aimed at improving the ability of health professionals to provide effective clinical prevention and public health services. Papers on health services research pertinent to prevention and public health are also published. The journal also publishes official policy statements from the two co-sponsoring organizations, review articles, media reviews, and editorials. Finally, the journal periodically publishes supplements and special theme issues devoted to areas of current interest to the prevention community.