国家神经系统疾病临床医学研究中心数据管理与共享系统

Data Management And Sharing System of China National Clinical Research Center for Neurological Diseases

《国家中心数据管理与共享系统操作说明书 —— 研究者部分》

Association of lymphocyte to monocyte ratio to cognitive impairment after acute ischemic stroke and transient ischemic attack: a multicenter cohort study

第一作者：左丽君,Dong Yanhong

通讯作者：李子孝

post stroke cognitive impairment hemoglobin albumin lymphocyte platelet

基本信息

2024-01-10

已发表文章

发表杂志：journal of inflammation

发表类型: Article

影响因子(IF): 3.2

PMID: 38223135 Pubmed原文链接 全文下载

主要研究背景及目的

神经炎症活性增加与精神和行为异常综合征有关。系统性炎症反应增加与认知障碍发生相关。越来越多研究发现神经免疫炎症在缺血性卒中病理中发挥重要作用。最易评定外周免疫的一般方法是血液分化白细胞的计数。此外，这些测量的比值包括中性粒细胞/淋巴细胞比值(Neutrophil to lymphocyte ratio,NLR)，血小板/淋巴细胞比(platelet to lymphocyte ratio,PLR)，全身免疫炎症指标(systemic immune-inflammation index,SII)和淋巴细胞/单核细胞比率(LMR)的变化能更好地反映外周免疫强度。最近研究报道NLR,PLR及淋巴细胞与单核细胞比值(lymphocyte to monocyte ratio,LMR)可作为基线炎症过程的新型生物标志物，也是缺血性脑卒中的重要预测指标。NLR、PLR和LMR急性缺血性卒中静脉溶栓后神经功能恶化的预测因子。急性期的NLR升高与卒中后3个月PSCI相关，但是样本量较小。另有研究发现，LMR的动态变化与心血管术后认知功能障碍发生相关。目前研究尚无LMR与PSCI的关系的研究。

方法

Methods: We recruited 1022 participants with AIS/TIA in this study from the Impairment of Cognition and Sleep (ICONS) study of the China National Stroke Registry-3 (CNSR-3). The HALP score was computed by the formula: hemoglobin (g/L)×albumin (g/L)×lymphocytes (/L) / platelets (/L), and was split into four layers according to the tertiles. They were divided into four groups according to quartiles of baseline HALP score. Patients’ cognitive functions were assessed by MoCA-Beijing at 2 weeks and at 12 months. Multiple logistic regression models were performed to evaluate the relationship between the HALP score and PSCI at 2 weeks and at 1 year follow-up.

结论

Conclusions: A low HALP score was found to be correlated with long-term PSCI, but we have not found short-term effect on PSCI. HALP score may aid in the early detection for PSCI.

主要结果

Results: Cognitive impairment was defined as MoCA-Beijing ≤22. Most patients were in 60s (61.59±11.00 years old) with a median (interquartile range) National Institute of Health Stroke Scale score of 3.00(4.00). They also had greater than primary school level of education. Approximately three quarter of patients were male (n=746, 72.99%). The HALP score was divided into quartiles, i.e. four layers: Q1≤36.56, Q2 = 36.56-48.83, Q3 = 48.83-65.08 and Q4≥65.08, respectively. the incidence of PSCI at 2 weeks was 49.21%. Among the 1022 participants, 331 participants (32.39%) patients suffered PSCI at 1 year follow-up. The Q1 layer showed the highest risk of 12-month PSCI after adjusting for confounding factors [(odds ratio (OR)=1.59, 95% confidence interval (CI)= 1.07~2.37, p=0.022)]. Patients with the lowest HALP score, i.e., Q1, showed significantly lower MoCA subtest domain scores for executive function, naming and attention.