急性脑梗死患者外周血中性粒细胞/淋巴细胞比值与颈动脉易损斑块的关系

The Relationship between neutrophil-to-lymphocyte ratioNLR and vulnerable plaque of carotid artery plaque in patients with Acute Cerebral iInfarction

摘要:

目的 探讨急性脑梗死（ACI）外周血中性粒细胞/淋巴细胞比值（NLR）与颈动脉易损斑块的关系。 方法 选取2016年9月—2018年1月于哈尔滨医科大学附属第一医院卒中病房住院的ACI患者271例。根据颈动 脉超声检查分为无斑块组及有斑块组，其中有斑块组分为稳定斑块组及易损斑块组，比较各组一般资料，中性粒 细胞计数、淋巴细胞计数、NLR值的差异。结果 斑块组吸烟史、NLR、中性粒细胞计数高于无斑块组，淋巴 细胞的计数低于无斑块组（P <0.05）。易损斑块组NLR、中性粒细胞计数及低密度脂蛋白高于稳斑块组，而淋巴 细胞的计数低于稳定斑块组（P <0.05）。NLR、低密度脂蛋白是颈动脉易损斑块的独立影响因素（P <0.05）， NLR值每增加1个单位，斑块为易损斑块的可能性是原来的1.400（95% CI：1.124，1.744）倍，低密度脂蛋白每 增加1个单位，斑块为易损斑块的可能性是原来的2.867（95% CI：1.238，6.640）倍。NLR对ACI患者颈动脉易 损斑块的ROC曲线下面积为0.65（95% CI：0.567，0.728），最佳截断点为2.79，此时的敏感性为0.69（95% CI： 0.593，0.777），特异性为0.59（95% CI：0.465，0.684）。结论 NLR增高对于评估ACI患者颈动脉粥样硬化易损 斑块具有一定的参考价值。

Abstract:

Objective To study the association of neutrophil-to-lymphocyte ratio (NLR) with vulnerable carotid artery plaque in patients with acute cerebral infarction (ACI). Methods The clinical data and blood biochemical data of 271 ACI patients in Department of Neurology were collected. According to carotid ultrasonography, 271 patients with ACI were divided into non-plaque group and plaque group. The plaque group was subdivided into stable plaque group and vulnerable plaque group according to the ultrasound features of plaques. The general clinical data, neutrophil counts, lymphocyte counts, and NLR were compared between groups. Results The number of patients with smoking history, neutrophil counts, and NLR values in the plaque group were higher than those in the non-plaque group (P < 0.05), whereas lymphocyte counts in the plaque group were lower than those in the non-plaque group (P < 0.05). The NLR, neutrophil counts, and low-density lipoprotein cholesterol (LDL-C) were higher in the vulnerable plaque group than those in the stable plaque group (P < 0.05), while lymphocyte counts in the vulnerable plaque group were lower than those in the stable plaque group (P < 0.05). Logistic regression analysis showed that the NLR [OR = 1.400 (95% CI: 1.124, 1.744)] and LDL-C [OR = 2.867 (95% CI: 1.238, 6.640)] were independent risk factors for vulnerable plaques in patients with ACI. The area under the receiver operating characteristic (ROC) curve of NLR in predicting vulnerable plaques in patients with ACI was 0.65 (95% CI: 0.567, 0.728). The optimal cut-off point was 2.79, and the sensitivity was 0.69 (95% CI: 0.593, 0.777) whereas the specificity was 0.59 (95% CI: 0.465, 0.684). Conclusions The increase of NLR level is of value for evaluating vulnerable carotid artery plaques in ACI patients.