NLR和LMR可以有效预测急性前循环大血管闭塞性卒中（ALVOS）患者机械取栓的不良结局

IF 1.8 4区医学 Q3 CLINICAL NEUROLOGY

Clinical Neurology and Neurosurgery Pub Date : 2025-04-29 DOI:10.1016/j.clineuro.2025.108925

Ruijing Xu , Fei Guo , Chunshui Yang , Feiqi Zhu

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引用次数: 0

摘要

目的探讨中性粒细胞与淋巴细胞比值（NLR）和淋巴细胞与单核细胞比值（LMR）对机械取栓术（MT）患者急性前循环大血管闭塞性卒中（ALVOS）不良预后的预测价值。材料,方法回顾性招募96例ALVOS行MT治疗的患者，将患者分为两组：预后良好组（3个月改良Rankin量表评分（mRS） 0-2分）和预后不良组（3个月mRS 3-6分）。采用Logistic回归分析检验影响ALVOS 3个月不良结局的独立危险因素。此外，我们还进行了受试者工作特征曲线（ROC）来估计NLR、LMR以及NLR和LMR联合对术后ALVOS不良结局的预测价值。结果46.9 %（45/96）的病例出现不良结局，53.1 %（51/96）的病例出现良好结局。在单因素回归分析中，基线NIHSS评分、症状性颅内出血和空腹血糖被纳入多因素二元logistic回归，结果显示NLR （OR 3.776, 95 %CI 1.067‐13.363,p = 0.039）和LMR （OR 0.092, 95 %CI 0.017‐0.0506,p = 0.006）是3个月时不良结局（mRS评分3-6）的独立预测因子。高NLR （>； 2.984）和低LMR （<； 3.775）与不良结局独立相关，且NLR和LMR联合预测水平（AUC = 0.941）高于单一指标(NLR, AUC = 0.876；LMR, AUC = 0.934)。结论NLR和LMR联合应用比NLR单独应用更能预测术后ALVOS的不良预后。

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NLR and LMR could powerfully predict unfavorable outcomes in patients with acute anterior circulation large vessel occlusion stroke (ALVOS) who underwent mechanical thrombectomy

Introduction

To investigate the predictive value of Neutrophil to lymphocyte ratio (NLR) and Lymphocyte to monocyte ratio (LMR) on unfavorable outcomes of acute anterior circulation large vessel occlusion stroke (ALVOS) in patients who underwent mechanical thrombectomy (MT).

Material & method

We retrospectively recruited 96 cases with ALVOS who underwent MT. These cases were divided into two groups including the favorable outcome group (3-month modified Rankin Scale scores (mRS) of 0–2) and the unfavorable outcome group (3-month mRS of 3-6). Logistic regression analysis was used to examine the independent risk factors of the 3-month unfavorable outcome of ALVOS. Moreover, we conducted a receiver operating characteristic curve (ROC) to estimate the valuable predictor of NLR, LMR, and the combination of NLR and LMR on unfavorable outcomes of ALVOS after MT.

Results

46.9 % (45/96) cases had an unfavorable outcome and 53.1 % (51/96) cases had a favorable outcome. In the univariate regression analysis, baseline NIHSS score, symptomatic intracranial hemorrhage, and fasting glucose were included in the multi-factor binary logistic regression, and this revealed that NLR (OR 3.776, 95 %CI 1.067‐13.363, p = 0.039) and LMR (OR 0.092, 95 %CI 0.017‐0.0506, p = 0.006) were independent predictors of unfavorable outcomes (mRS score 3-6) at 3-month. Higher NLR (> 2.984) and lower LMR (< 3.775) were independently associated with unfavorable outcomes, and the combined predictive levels of both NLR and LMR (AUC = 0.941) were higher than single indicators (NLR, AUC = 0.876; LMR, AUC = 0.934).

Conclusions

The combination of NLR and LMR was a more powerful predictor of unfavorable outcomes of ALVOS after MT than NLR alone.

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来源期刊

Clinical Neurology and Neurosurgery 医学-临床神经学

CiteScore

3.70

自引率

5.30%

发文量

358

审稿时长

46 days

期刊介绍： Clinical Neurology and Neurosurgery is devoted to publishing papers and reports on the clinical aspects of neurology and neurosurgery. It is an international forum for papers of high scientific standard that are of interest to Neurologists and Neurosurgeons world-wide.