炎症指标(NLR/PLR/SII/NMLR)与近期皮质下小梗死患者90天功能预后的相关性研究
Association between Inflammatory Markers (NLR/PLR/SII/NMLR) and 90-Day Functional Outcomes in Patients with Recent Small Subcortical Infarction
摘要: 目的：探讨基线血细胞衍生炎症指标，如中性粒细胞与淋巴细胞比值(NLR)、血小板与淋巴细胞比值(PLR)、全身免疫炎症指数(SII)、中性粒细胞与单核细胞之和与淋巴细胞比值(NMLR)与近期皮质下小梗死(RSSI)患者90天功能预后的相关性，并评价其预测价值。方法：前瞻性连续纳入2024年8月至2025年4月期间入住安徽医科大学第二附属医院的158例RSSI患者。根据90天改良Rankin量表(mRS)评分将其分为预后良好组(0~2分，134例)和预后不良组(3~6分，24例)。收集患者临床资料及血常规数据，计算NLR、PLR、SII和NMLR。结果：158例患者中24例预后不良。预后不良组年龄更大、入院NIHSS评分更高，NLR、PLR、SII和NMLR水平均明显升高。多因素Logistic回归分析显示，NLR、PLR、SII及NMLR均与90天不良预后独立相关(均P < 0.05)。ROC曲线分析显示，上述指标对不良预后均有一定预测价值，其中SII预测效能相对较高(AUC = 0.701)。结论：NLR、PLR、SII和NMLR与RSSI患者90天不良预后密切相关，可作为简便易得的炎症标志物用于早期风险评估。
Abstract: Objective: To investigate the association between baseline blood cell-derived inflammatory markers, including the neutrophil-to-lymphocyte ratio (NLR), platelet-to-lymphocyte ratio (PLR), systemic immune-inflammation index (SII), and neutrophil-monocyte-to-lymphocyte ratio (NMLR), and 90-day functional outcomes in patients with recent small subcortical infarction (RSSI), and to evaluate their predictive value. Methods: A total of 158 patients with RSSI who were admitted to the Second Affiliated Hospital of Anhui Medical University between August 2024 and April 2025 were prospectively and consecutively enrolled. According to the 90-day modified Rankin Scale (mRS) score, patients were divided into a favorable outcome group (mRS 0~2, n = 134) and an unfavorable outcome group (mRS 3~6, n = 24). Clinical data and routine blood test results were collected, and NLR, PLR, SII, and NMLR were calculated. Results: Among the 158 patients, 24 experienced poor outcomes. Compared to the favorable outcome group, the poor outcome group was significantly older, had higher admission NIHSS scores, and exhibited significantly elevated levels of NLR, PLR, SII, and NMLR. Multivariate logistic regression analysis demonstrated that NLR, PLR, SII, and NMLR were all independently associated with unfavorable 90-day outcomes (P < 0.05). Receiver operating characteristic (ROC) curve analysis showed that all these markers had predictive value for unfavorable outcomes, among which SII showed relatively better predictive performance (AUC = 0.701). Conclusion: NLR, PLR, SII, and NMLR are closely associated with 90-day poor functional outcomes in patients with RSSI. These parameters can serve as easily accessible inflammatory biomarkers for early clinical risk assessment.
文章引用：陈帆, 邵健硕, 张梦秋, 李娟, 胡晓, 王孜杰, 李琦. 炎症指标(NLR/PLR/SII/NMLR)与近期皮质下小梗死患者90天功能预后的相关性研究[J]. 临床医学进展, 2026, 16(4): 3117-3125. https://doi.org/10.12677/acm.2026.1641570

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