入院NLR与轻型急性缺血性卒中72小时内早期神经功能恶化的关联

Association between Admission Neutrophil-to-Lymphocyte Ratio and Early Neurological Deterioration within 72 Hours in Minor Acute Ischemic Stroke

摘要: 目的：探讨入院中性粒细胞/淋巴细胞比值(NLR)与轻型急性缺血性卒中(AIS)患者72小时内早期神经功能恶化(END)的关联。方法：回顾性纳入轻型AIS患者80例，比较END与非END组NLR水平，并以ROC曲线评估NLR对END的判别效能，并在事件数有限情况下对低密度脂蛋白与高血压进行有限校正。结果：END发生率为15.0%。END组NLR高于非END组(P < 0.001)。以NLR中位数分组后，高NLR组END发生率高于低NLR组(P = 0.026)。ROC曲线AUC = 0.865。多因素回归提示NLR升高与END发生相关(P = 0.001)。结论：入院NLR升高与轻型AIS患者72小时内END发生相关，可作为早期风险提示指标之一，仍需更大样本研究验证。

Abstract: Objective: To investigate the association between admission neutrophil-to-lymphocyte ratio (NLR) and early neurological deterioration (END) within 72 hours in patients with minor acute ischemic stroke (AIS). Methods: A total of 80 patients with minor AIS were retrospectively enrolled. Admission NLR levels were compared between the END and non-END groups. Receiver operating characteristic (ROC) curve analysis was used to evaluate the discriminative ability of NLR for END. Given the limited number of END events, only limited adjustment was performed for low-density lipoprotein cholesterol (LDL-C) and hypertension in the multivariable analysis. Results: END occurred in 15.0% of patients. Admission NLR was significantly higher in the END group than in the non-END group (P < 0.001). After dichotomization according to the median NLR value, the incidence of END was significantly higher in the high-NLR group than in the low-NLR group (P = 0.026). ROC analysis showed an AUC of 0.865. Multivariable analysis showed that elevated NLR was associated with END (P = 0.001). Conclusion: Elevated admission NLR is associated with END within 72 hours in patients with minor AIS and may serve as an early indicator of END risk. Further studies with larger sample sizes are needed for validation.