中性粒细胞与淋巴细胞比值与卒中后抑郁研究

Association between Neutrophil-to-lymphocyte Ratio and Post-stroke Depression

目的探讨中性粒细胞与淋巴细胞比值(NLR)与卒中后抑郁(PSD)的关系。方法连续纳入270例急性缺血性卒中患者。入院后第2天晨起检测中性粒细胞及淋巴细胞计数。以门诊或病房方式随访3个月,根据是否诊断为抑郁,分为PSD组和对照组。采用多因素Logistic回归模型分析与PSD相关的因素,应用ROC曲线评估NLR对PSD的预测价值。结果发生PSD共116例(42.90%)。多因素Logistic回归分析显示,mRS评分、NIHISS评分、同型半胱氨酸及NLR水平升高(OR=2.805,P<0.001,95%CI:2.123~4.126)均是PSD的独立危险因素。ROC曲线显示,NLR预测PSD最佳临界值为4.165,其敏感性为82.8%,特异性为83.8%,曲线下面积为0.849。结论入院时NLR水平升高与PSD相关,可能对于PSD早期诊断和临床干预具有重要价值。

Objective:To investigate the relationship between neutrophil-to-lymphocyte ratio and post-stroke depression.Methods:270 AIS patients were consecutively enrolled in thisstudy;the number of blood platelet and lymphocytewere measured in the next morning after admission.All cases were divided into PSD group and non-PSD group based on the diagnosis results of depression from 3 months follow-up.Multivariate logistic regression analysis were used to identify the risk factors of PSD.The ROC curve analysis was performed to evaluate the predictive value of NLR for PSD.Result:Multivariate Logistic regression analysis showed that mRS score at the third month of follow-up,NIHSS score,Hcy and elevation of NLR level(OR=2.805,P<0.001,95%CI:2.123-4.126)were independent risk factors for PSD.Receiver operating curve showed predictive cutoff value of neutrophil/lymphocyte ratio for Post-stroke depression(sensitivity=0.828;1-specificity=0.162;NLR=4.165;area under curve(AUC)=0.848).Conclusion:Increased NLRs at admission are found to be correlated with PSD and may have great significance in early diagnosis,intervention and clinical prevention for PSD.