中风患者全身炎症指标与全因死亡率之间的关系：利用英国生物库数据进行的前瞻性研究。

IF 2 4区医学 Q3 NEUROSCIENCES

Journal of Stroke & Cerebrovascular Diseases Pub Date : 2024-10-10 DOI:10.1016/j.jstrokecerebrovasdis.2024.108076

Aimin Wang MPH , Fenglin Wang MPH , Yiming Huang MPH , Qingxia Cui MS , Yaqi Xu MPH , Wenjing Zhang MPH , Guiya Guo MPH , Wangchen Song MPH , Yujia Kong PhD , Qinghua Wang PhD , Suzhen Wang PhD , Fuyan Shi PhD

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引用次数: 0

摘要

背景和目的：全身免疫炎症指数（SII）、中性粒细胞与淋巴细胞比值（NLR）、血小板与淋巴细胞比值（PLR）和淋巴细胞与单核细胞比值（LMR）是用于确定各种疾病预后的新型炎症生物标志物。然而，这些全身炎症标志物对中风患者全因死亡率的影响仍不清楚：我们利用英国生物库的数据进行了前瞻性分析。总共纳入了 6020 名符合条件的患者。我们使用随机生存森林（RSF）和 Cox 比例危险模型研究了全身炎症指标对全因死亡率的影响。RSF选择的Cox模型中的协变量调整包括年龄、性别、体重指数（BMI）、汤森剥夺指数、吸烟状况、酒精摄入频率、睡眠时间、糖尿病和恶性肿瘤：在全身炎症指标的边际效应图和限制性立方样条分析中，LMR呈线性负相关，NLR呈线性正相关，SII和PLR呈U形相关。经过协变量调整后，LMR 的全因死亡风险增加了 14% 结论：SII、NLR、PLR 和 LMR 与脑卒中患者的全因死亡率显著相关。RSF 模型确定的阈值有可能完善中风护理中的预后决策。

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Association between systemic inflammatory markers and all-cause mortality in patients with stroke: A prospective study using data from the UK Biobank

Background and aims

The systemic immune-inflammation index (SII), neutrophil-to-lymphocyte ratio (NLR), platelet-to-lymphocyte ratio (PLR), and lymphocyte-to-monocyte ratio (LMR) are novel inflammatory biomarkers used to determine various disease prognoses. However, the effects of these systemic inflammatory markers on all-cause mortality in patients with stroke remain unclear.

Methods

We used data from the UK Biobank for this prospective analysis. Overall, 6,020 eligible individuals were included. Over a median follow-up of 13.4 years, 1,233 participants died. We examined the effects of systemic inflammatory markers on all-cause mortality using random survival forest (RSF) and Cox proportional hazards models. Covariate adjustments in the Cox model, selected by RSF, included age, sex, body mass index (BMI), Townsend deprivation index, smoking status, alcohol intake frequency, sleep duration, diabetes, and malignant neoplasms.

Results

In the marginal effect plots and restricted cubic spline analysis for systemic inflammatory markers, LMR exhibited a linear negative correlation, NLR showed a linear positive correlation, and SII and PLR demonstrated a U-shaped association. After covariates were adjusted, the all-cause mortality risk increased by 14 % for LMR <4 (hazards ratio [HR]: 1.14, 95 % confidence interval [CI]: 1.01–1.29; p= 0.03), by 26 % for NLR ≥2 (HR: 1.26; 95 % CI: 1.11–1.43; p < 0.001),by 26 % for PLR ≥175 (HR: 1.26; 95 % CI: 1.07–1.47; p < 0.001), and by 31 % for SII ≥526 (HR: 1.31; 95 % CI, 1.16–1.47; p= 0.014). In addition, sensitivity analyses, excluding participants who had been followed-up for <2 years and those with malignant neoplasms, yielded results consistent with those of previous research.

Conclusion

SII, NLR, PLR, and LMR significantly correlate with all-cause mortality in stroke patients. Thresholds established by the RSF model could potentially refine prognostic decision-making in stroke care.

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来源期刊

Journal of Stroke & Cerebrovascular Diseases Medicine-Surgery

CiteScore

5.00

自引率

4.00%

发文量

583

审稿时长

62 days

期刊介绍： The Journal of Stroke & Cerebrovascular Diseases publishes original papers on basic and clinical science related to the fields of stroke and cerebrovascular diseases. The Journal also features review articles, controversies, methods and technical notes, selected case reports and other original articles of special nature. Its editorial mission is to focus on prevention and repair of cerebrovascular disease. Clinical papers emphasize medical and surgical aspects of stroke, clinical trials and design, epidemiology, stroke care delivery systems and outcomes, imaging sciences and rehabilitation of stroke. The Journal will be of special interest to specialists involved in caring for patients with cerebrovascular disease, including neurologists, neurosurgeons and cardiologists.