中性粒细胞／淋巴细胞比值与急性缺血性卒中患者脑微出血的相关性

Correlation between neulrophil to lymphocyte ratio and cerebral microbleeds in patients with ischemic stroke

目的探讨急性缺血性卒中患者中性粒细胞/淋巴细胞比值（neutrophil to lymphocyte ratio, NLR）与脑微出血（cerebral microbleeds, CMBs）的相关性。方法连续纳入住院的急性缺血性卒中患者。采用梯度回波T2＊加权成像评估CMBs及其数量。采用单变量分析比较CMBs组与非CMBs组的基线资料，利用多变量logistic回归分析确定NLR与CMBs的独立相关性。结果共纳入218例急性缺血性卒中患者，其中66例（30.3%）伴有CMBs。非CMBs组年龄[（64.7 ± 6.6）岁对（66.9 ± 8.6）岁；t＝2.052，P＝0.041]、高敏C反应蛋白水平[7.0（2.3～13.9）mg/L对8.9（4.0～28.1）mg/L；Z＝2.008，P＝0.045]和NLR[1.9（1.4～2.9）对2.3（1.7～3.6）；Z＝2.071，P＝0.038]显著低于CMBs组。多变量logistic回归分析显示，NLR（优势比1.276，95%可信区间1.008～1.670；P＝0.045）和年龄（优势比1.044，95%可信区间1.002～1.087；P＝0.040）是CMBs的独立危险因素。Spearman相关分析显示，NLR与CMBs严重程度呈显著正相关（r＝0.210，P＝0.007）。结论在急性缺血性卒中患者中，NLR与CMBs及其严重程度相关，提示炎性反应可能参与了CMBs的发生。

ObjectiveTo investigate the correlation between neutrophil to lymphocyte ratio （NLR） and cerebral microbleeds （CMBs） in patients with acute ischemic stroke.MethodsThe consecutive inpatients with acute ischemic stroke were prospectively enrolled. Gradient echo-T2＊-weighted imaging was used to evaluate CMBs and their quantity. Univariate analysis was used to compare the baseline data between the CMB group and the non-CMB group. Multivariable logistic regression analysis was used to identify the independent correlation between NLR and CMBs.ResultsA total of 218 patients with acute ischemic stroke were prospectively enrolled, including 66 （30.3%） with CMBs. The age （ 64.7±6.6 years vs. 66.9±8.6 years; t=2.052, P=0. 041）, high sensitive C-reactive protein （7.0[2.3-13.9] mg/L vs. 8.9[4.0-28.1] mg/L; Z=2.008, P=0.045） and NLR （1.9[1.4-2.9] vs. 2.3[1.7-3.6]; Z=2.071, P=0.038） in the non-CMB group were significantly lower than those of the CMB group. Multivariate logistic regression analysis showed that NLR （odds ratio 1.276, 95% confidence interval 1.008-1.670; P=0.045） and age （odds ratio 1.044, 95% confidence interval 1.002-1.087; P=0.040） were the independent risk factor for CMBs. Spearman correlation analysis showed that NLR was significantly positively correlated with the severity of CMBs （r=0.210, P=0.007）.ConclusionsIn patients with acute ischemic stroke, NLR was associated with CMBs and their severity, suggesting that inflammatory reaction might be involved in the occurrence of CMBs.