天津医药

天津医药 ›› 2022, Vol. 50 ›› Issue (5): 493-497.doi: 10.11958/20212251

• 临床研究 • 上一篇    下一篇

中性粒细胞淋巴细胞比值、淋巴细胞单核细胞比值与症状性颅内动脉粥样硬化性狭窄的关系#br#

胡明哲1，陈香岩2，吴光亮3，乔利军3，蔡业锋3△   

  1. 1山东省中医院脑病科（邮编255014）；2淄博市中医医院康复科；3广东省中医院脑病科
  • 收稿日期:2021-10-08 修回日期:2022-01-13 出版日期:2022-05-15 发布日期:2022-07-04
  • 基金资助:
    广东省中医药管理局科研计划项目（20201145）；广东省自然科学基金项目（2018A0303130053）

Research on the correlation between neutrophil lymphocyte ratio, lymphocyte monocyte ratio and symptomatic intracranial atherosclerotic stenosis#br#

HU Mingzhe1, CHEN Xiangyan2, WU Guangliang3, QIAO Lijun3, CAI Yefeng3△   

  1. 1 Department of Neurology, Shandong Provincial Hospital of Traditional Chinese Medicine, Jinan 255014, China; 2 Department of Rehabilitation, Zibo City Hospital of Traditional Chinese Medicine; 3 Department of Neurology, Guangdong Hospital of Traditional Chinese Medicine
  • Received:2021-10-08 Revised:2022-01-13 Published:2022-05-15 Online:2022-07-04

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摘要： 目的　探讨中性粒细胞淋巴细胞比值（NLR）、淋巴细胞单核细胞比值（LMR）与症状性颅内动脉粥样硬化性狭窄（sICAS）的关系。方法　采用回顾性分析，将649例sICAS患者依据责任血管狭窄程度分为轻度（58例）、中度（202例）及重度狭窄组（389例）；依据入院时美国国立卫生研究院神经功能缺损评分（NIHSS）分为轻度（504例）及中度缺损组（145例）。收集基线资料、实验室及影像学检查结果。采用Logistic回归探讨影响颅内动脉狭窄程度、神经功能缺损程度的独立影响因素；采用受试者工作特征（ROC）曲线探讨NLR、LMR对神经功能缺损程度的预测价值。结果 （1）女性（OR=3.132，95%CI：1.008~9.732）、入院时高NIHSS评分（OR=1.343，95%CI：1.020~1.769）、高LDL-C（OR=7.341，95%CI：1.609~33.502）、高Hcy（OR=1.320，95%CI：1.069~1.630）是影响sICAS颅内动脉中度狭窄的独立危险因素；高Hcy（OR=1.377，95%CI：1.118~1.697）是影响sICAS颅内动脉重度狭窄的独立危险因素。（2）高Hcy（OR=1.106，95%CI：1.055~1.158）、高NLR（OR=1.612，95%CI：1.340~1.939）是影响sICAS神经功能缺损程度的独立危险因素。（3）ROC曲线结果提示NLR对sICAS患者神经功能缺损程度的预测价值一般（ROC曲线下面积为0.618，95%CI：0.567~0.668，P＜0.01），当NLR为3.5时诊断效能最高；LMR对sICAS患者神经功能缺损程度无预测价值（ROC曲线下面积为0.519，95%CI：0.465~0.573，P＞0.05）。结论　NLR与sICAS神经功能缺损程度有关，NLR升高可能是神经功能缺损程度加重的独立危险因素。

关键词: 颅内动脉硬化, 症状性颅内动脉粥样硬化性狭窄, 中性粒细胞淋巴细胞比值, 淋巴细胞单核细胞比值, 神经功能缺损程度

Abstract: Objective　To investigate the correlation between neutrophil lymphocyte ratio (NLR), lymphocyte monocyte ratio (LMR) and the pathogenesis of symptomatic intracranial atherosclerotic stenosis (sICAS). Methods　By retrospective analysis, a total of 649 sICAS patients were divided into the mild (58 cases), the moderate (202 cases) and the severe stenosis groups (389 cases) according to the severity of responsible artery stenosis. And the patients were divided into the mild neurological defect group (504 cases) and the moderate neurological defect groups (145 cases) according to the National Institutes of Health Stroke Scale score. Baseline data, laboratory and imaging outcomes were collected. Logistic regression analysis was used to investigate the independent risk factors affecting the degree of intracranial artery stenosis and neurological defect. Receiver operating characteristic curve (ROC) was used to explore the efficacy of NLR or LMR in detecting the degree of intracranial artery stenosis and neurological defects. Results　(1) Female (OR=3.132, 95%CI: 1.008-9.732), high NIHSS score at admission (OR=1.343, 95%CI: 1.020-1.769 ), high LDL-C (OR=7.341, 95%CI: 1.609-33.502) and high homocysteine (Hcy, OR=1.320, 95%CI: 1.069-1.630) were independent risk factors for the moderate intracranial arterial stenosis of sICAS. The high Hcy (OR=1.377, 95%CI:1.118-1.697) was an independent risk factor for severe intracranial arterial stenosis of sICAS. (2) The high Hcy (OR=1.106, 95%CI: 1.055-1.158) and high NLR (OR=1.612, 95%CI: 1.340-1.939) were independent risk factors for neurological defect of sICAS. (3) ROC curve indicated that NLR had a low predictive value for the degree of neurological defect in patients (95%CI: 0.567-0.668, P＜0.01) while LMR had no predictive value (95%CI: 0.465-0.573, P＞0.05). (3) When NLR was 3.5, the diagnostic efficiency was the highest. Conclusion　NLR is correlated with the degree of neurological defect of sICAS, and the increased NLR may be an independent risk factor for the aggravation of neurological defect. 

Key words: intracranial arteriosclerosis, symptomatic intracranial atherosclerotic stenosis, neutrophil lymphocyte ratio, lymphocyte monocyte ratio, neurological deficit

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