摘要：

目的: 分析急性缺血性卒中患者与健康对照者特定外周血炎性标志物差异及其临床意义。方法: 选择2021年1月至2023年1月湖北省洪湖市人民医院收治的44例急性缺血性卒中患者及29例性别、年龄相匹配的健康对照者, 分析两组外周血白细胞计数、中性粒细胞计数、淋巴细胞计数、单核细胞计数、血小板计数、血小板/淋巴细胞比值(PLR)和淋巴细胞/单核细胞比值(LMR)差异; 采用Pearson相关分析及偏相关分析探究PLR、LMR与疾病严重程度[入院时美国国立卫生研究院卒中量表(NIHSS)]的相关性。结果: 与健康对照者相比, 急性缺血性卒中患者外周血中性粒细胞计数(t = 2.644, P = 0.010)及PLR(t = 3.017, P = 0.004)升高、淋巴细胞计数(t = 3.164, P = 0.002)及LMR(t = 3.416, P = 0.001)降低。急性缺血性卒中患者外周血PLR与入院时NIHSS评分呈正相关(r =0.152, P = 0.034), LMR与入院时NIHSS评分呈负相关(r =-0.154, P = 0.033)。结论: 急性缺血性卒中患者外周血中性粒细胞计数和PLR升高, 淋巴细胞计数和LMR降低, 这些炎性标志物与病情严重程度相关, 有助于评估和预测疾病进展。

关键词: 缺血性卒中, 炎症, 生物标记, 单核细胞, 淋巴细胞, 血小板计数

Abstract:

Objective: To investigate the differences in specific peripheral blood inflammatory markers between patients with acute ischemic stroke and healthy controls, exploring the changes in these markers and their clinical significance. Methods: A total of 44 patients with acute ischemic stroke from January 2021 to January 2023 in Honghu City People's Hospital, and 29 healthy controls matched to the age and sex were enrolled. Blood inflammatory markers, including peripheral blood white blood cell count, neutrophil count, lymphocyte count, monocyte count, platelet count, platelet to lymphocyte ratio (PLR) and lymphocyte to monocyte ratio (LMR), were analyzed and compared between the 2 groups, and their associations with disease severity[National Institutes of Health Stroke Scale (NIHSS) at admission] were evaluated. Results: Compared with healthy controls, the levels of neutrophil (t = 2.644, P = 0.010) and PLR (t = 3.017, P = 0.004) were elevated, while levels of lymphocyte (t = 3.164, P = 0.002) and LMR (t = 3.416, P = 0.001) were decreased in patients with acute ischemic stroke. Partial correlation analysis showed that peripheral blood PLR in patients with acute ischemic stroke was positively correlated with NIHSS score at admission (r = 0.152, P = 0.034), while LMR was negatively correlated with NIHSS score at admission (r =-0.154, P = 0.033). Conclusions: Elevated neutrophil and PLR, alongside decreased lymphocyte and LMR, were observed in acute ischemic stroke patients. These inflammatory markers correlate with disease severity and may aid in the assessment and prediction of disease progression.

Key words: Ischemic stroke, Inflammation, Biomarkers, Monocytes, Lymphocytes, Platelet count