全身炎症反应指数、血小板与淋巴细胞比率与急性缺血性卒中严重程度的相关性研究

Correlation of Systemic Inflammatory Response Index and Platelet-to-Lymphocyte Ratio with Acute Ischemic Stroke Severity

摘要: 目的：炎症在急性缺血性卒中(AIS)的病理生理学中起着关键作用。本研究旨在探讨全身炎症反应指数(SIRI)、血小板与淋巴细胞比率(PLR)与AIS严重程度之间的关系。并评估炎症标志物对AIS病情严重程度的预测价值。方法：本研究回顾性纳入符合标准的417例AIS患者，入院时采集血细胞计数，并采用美国国立卫生研究院卒中量表(NIHSS)评估卒中严重程度。SIRI定义为中性粒细胞计数 × 单核细胞计数/淋巴细胞计数。PLR定义为血小板计数/淋巴细胞计数。采用多元Logistic回归分析影响缺血性脑卒中严重程度的独立危险因素。并绘制受试者工作特征(ROC)曲线评估SIRI和PLR在脑卒中疾病严重程度中的判别效能。结果：中重度卒中组的SIRI和PLR水平均显著高于轻度卒中组[SIRI: 1.30 (0.81~1.80) vs. 0.88 (0.62~1.26), P < 0.001; PLR: 141.45 (109.30~191.04) vs. 121.23 (92.65~150.68), P < 0.001]。单因素和多因素Logistic回归分析进一步表明，SIRI (OR: 1.877, 95% CI: 1.272~2.772, P = 0.002)和PLR (OR: 1.005, 95% CI: 1.001~1.010, P = 0.022)均与卒中严重程度独立相关。ROC曲线分析显示，SIRI (AUC = 0.679，灵敏度为0.567，特异度为0.728)和PLR (AUC = 0.634，灵敏度为0.653，特异度为0.592)对脑卒中严重程度具有中等偏低的预测能力，其中SIRI的判别效能略优于PLR。结论：SIRI和PLR与入院时的卒中严重程度显著相关，可作为与疾病严重程度相关的辅助炎症生物标志物。然而，其预测能力有限，不能替代标准的临床评估。未来仍需开展大样本、多中心研究进一步验证。

Abstract: Objective: Inflammation plays a critical role in the pathophysiology of acute ischemic stroke (AIS). This study aimed to investigate the relationship between the systemic inflammatory response index (SIRI), platelet-to-lymphocyte ratio (PLR), and AIS severity, as well as to evaluate the predictive value of these inflammatory markers for stroke severity. Methods: This retrospective study enrolled 417 eligible AIS patients. Blood cell counts were collected upon admission, and stroke severity was assessed using the National Institutes of Health Stroke Scale (NIHSS). SIRI was defined as neutrophil count × monocyte count/lymphocyte count. PLR was defined as platelet count/lymphocyte count. Multivariate Logistic regression analysis was used to identify independent risk factors associated with stroke severity. Receiver operating characteristic (ROC) curves were plotted to assess the discriminatory ability of SIRI and PLR for stroke severity. Results: The moderate-to-severe stroke group exhibited significantly higher SIRI and PLR levels compared to the mild stroke group [SIRI: 1.30 (0.81~1.80) vs. 0.88 (0.62~1.26), P < 0.001; PLR: 141.45 (109.30~191.04) vs. 121.23 (92.65~150.68), P < 0.001]. Univariate and multivariate Logistic regression analyses further demonstrated that SIRI (OR: 1.877, 95% CI: 1.272~2.772, P = 0.002) and PLR (OR: 1.005, 95% CI: 1.001~1.010, P = 0.022) were independently associated with stroke severity. ROC curve analysis showed that SIRI (AUC = 0.679, sensitivity = 0.567, specificity = 0.728) and PLR (AUC = 0.634, sensitivity = 0.653, specificity = 0.592) had relatively low-to-moderate predictive ability for stroke severity, with SIRI showing slightly better discriminatory performance than PLR. Conclusion: Both SIRI and PLR were significantly associated with stroke severity at admission and may serve as auxiliary inflammatory biomarkers related to disease severity. However, their predictive value is limited and cannot replace standard clinical assessments. Large-scale, multicenter studies are needed for further validation.