[1]袁　丹a,郭晓敏a,刘　波b.外周血 NLR联合 PLR对动脉粥样硬化性脑梗死诊断及预测斑块稳定性的价值研究[J].现代检验医学杂志,2022,37(01):199-202.[doi:10.3969/j.issn.1671-7414.2022.01.041]
　YUAN Dana,GUO Xiao-mina,LIU Bob.Value of Peripheral Blood NLR Combined with PLR in Diagnosis of Atherosclerotic Cerebral Infarction and Prediction ofPlaque Stability[J].Journal of Modern Laboratory Medicine,2022,37(01):199-202.[doi:10.3969/j.issn.1671-7414.2022.01.041]
点击复制

外周血 NLR联合 PLR对动脉粥样硬化性脑梗死诊断及预测斑块稳定性的价值研究()
分享到：

《现代检验医学杂志》[ISSN:/CN:]

卷:
第37卷
期数:
2022年01期
页码:
199-202
栏目:
检验与临床
出版日期:
2022-01-15

文章信息/Info

Title:
Value of Peripheral Blood NLR Combined with PLR in Diagnosis of Atherosclerotic Cerebral Infarction and Prediction ofPlaque Stability
文章编号:
1671-7414（2022）01-199-04
作者:
袁　丹a; 郭晓敏a; 刘　波b
（陕西省人民医院a. 神经内二科；b. 超声科，西安 710068）
Author(s):
YUAN Dana; GUO Xiao-mina; LIU Bob
（a. Department of Neurology; b. Department of Ultrasound, Shaanxi Provincial People’s Hospital, Xi’an 710068, China）
关键词:
动脉粥样硬化性脑梗死; 斑块稳定性; 中性粒细胞与淋巴细胞比值; 血小板与淋巴细胞比值
分类号:
R743.33；R446.11
DOI:
10.3969/j.issn.1671-7414.2022.01.041
文献标志码:
A
摘要:
目的　探究外周血中性粒细胞与淋巴细胞比值（ NLR）联合血小板与淋巴细胞比值（ PLR）在诊断动脉粥样硬化性脑梗死（ ACI）与预测斑块稳定性的价值。方法　选取陕西省人民医院神经内二科 2020年 1月 ~2021年 1月住院治疗的 ACI患者 54例作为脑梗死组，另选取同期健康体检者 65例作为对照组。均进行颈动脉超声检查、外周血 NLR，PLR检测，比较两组外周血 NLR和 PLR水平。采用受试者工作（ ROC）曲线探究 NLR和 PLR诊断 ACI的价值，对比不同稳定性斑块患者外周血 NLR和 PLR水平，探究二者之间关系及与斑块稳定性的相关性。结果　脑梗死组外周血 NLR（3.16±0.17 vs 2.23±0.12）和 PLR（133.45±5.02 vs 111.04±7.56）水平高于对照组，差异均有统计学意义（t=4.723，
Abstract:
Objective　To explore the value of peripheral blood neutrophil lymphocyte ratio (NLR) combined with plateletlymphocyte ratio (PLR) in the diagnosis of atherosclerotic cerebral infarction CACI and prediction of plaque stability. Methods　54 patients with ACI hospitalzed in the Second Department of Neurology of Shaanxi Provincial Hospital from January 2020to January 2021 were selected as the cerebral infarction group, and 65 healthy subjects in the same period were selected as thecontrol group. Carotid ultrasound, peripheral blood NLR and PLR were performed to compare the levels of NLR and PLR inthe two group. The receiver operating(ROC) curve was used to explore the value of NLR and PLR in the diagnosis of ACI. Thelevels of NLR and PLR in peripheral bolld of patients with different stable plaques were compared to explore the relationshipbetween NLR and PLR and the stability of plaques. Result　The levels of NLR and PLR in cerebral infarction group were higherthan those in healthy control group (NLR 3.16±0.17 vs 2.23±0.12；PLR 133.45±5.02 vs 111.04±7.56), the differences werestatistically significant (t = 4.723, 2.150, P < 0.05). The value of NLR combined with PLR in the diagnosis of ACI was betterthan their individual diagnostic value (AUC 0.779, 95%CI 0.677~0.881). The levels of NLR and PLR in patients with vulnerableplaque > patients with stable plaque > patients without plaque (NLR 3.21±1.05 vs 1.88±0.61, 1.27±0.23；PLR 131.98±45.91vs 99.85±34.22, 73.07±18.55), and the difference was statistically significant (F=33.38, 12.30, all P < 0.05). Multivariatelogistic regression analysis suggested that NLR was an independent risk factor for vulnerable plaque(P<0.01). But PLR was notan independent risk factor of vulnerable plaque (P = 0.475). Conclusion　The levels of NLR and PLR in peripheral blood arehelpful for the diagnosis of ACI, and NLR is an independent risk factor for the occurrence of unstable carotid plaque.

参考文献/References:

[1] 中国脑卒中防治报告编写组.《中国脑卒中防治报告2019》概要[J]. 中国脑血管病杂志, 2020, 17 (5):272-281.Report on Stroke Prevention and Treatment in ChinaWriting Group. Brief report on stroke preventionand treatment in China,2019 [J].Chinese Journal ofCerebrovascular Diseases, 2020，17 (5): 272-281.
[2] LEGEIN B, TEMMERMAN L,BIESSEN E A L, etal. Inflammation and immune system interactions inatherosclerosis[J].Cellular and Molecular Life Sciences,2013, 70(20): 3847-3869.
[3] LIBBY P. History of discovery: inflammation inatherosclerosis[J]. Arteriosclerosis Thrombosis &Vascular Biology, 2012, 32(9):2045-2051.
[4] ACET H, ERTA? F, AKIL M A, et al. New inflammatorypredictors for non-valvular atrial fibrillation:echocardiographic epicardial fat thickness and neutrophilto lymphocyte ratio[J]. the International Journal ofCardiovascular Imaging, 2014, 30(1): 81-89.
[5] 陈青文, 李丹丹. 冠心病患者外周血中性粒细胞/ 淋巴细胞比值与冠脉狭窄程度的相关性研究[J]. 现代检验医学杂志,2020,35(6):98-101.CHEN Qingwen, LI Dandan. Correlation betweenthe degree of coronary stenosis and the neutrophil/lymphocyte ratio in patients with coronary arterydisease [J].Journal of Modern Laboratory Medicine,2020,35 (6):98-101.
[6] HYUN S, KWON S, CHO S Y, et al. Can the neutrophil-to-lymphocyte ratio appropriately predict carotidartery stenosis in patients with ischemic stroke?-A retrospectivestudy[J].Journal of Stroke & CerebrovascularDiseases, 2015, 24(11): 2646-2651.
[7] 田慧军. 脑梗死患者血小板与淋巴细胞比值中性粒细胞与淋巴细胞比值红细胞沉降率和超敏C 反应蛋白相关性分析[J]. 山西医药杂志,2019,48(16):2002-2004．TIAN Huijun. Platelet lymphocyte ratio, neutrophillymphocyte ratio, erythrocyte sedimentation rate andhigh sensitivity C-reactive protein in patients withcerebral infarction [J]. Shanxi Medical Journal, 2019,48(16): 2002-2004.
[8] 中华医学会神经病学分会, 中华医学会神经病学分会脑血管病学组. 中国急性缺血性脑卒中诊治指南2018[J]. 中华神经科杂志,2018,51(9):666-682.Chinese Society of Neurology，Chinese Stroke Society,Chinese Medical Association. Chinese guidelines fordiagnosis and treatment of acute ischemic stroke 2018 [J].Chinese Journal of Neurology, 2018, 51 (9): 666-682.
[9] GLASS C K, WITZTUM J L. Atherosclerosis. the roadahead[J]. Cell, 2001, 104(4): 503-516.
[10] SOEHNLEIN O. Multiple roles for neutrophils inatherosclerosis[J].Circulation Research, 2012, 110(6):875-888.
[11] DE MEYER S F, DENORME F, LANGHAUSER F,et al. Thromboinflammation in stroke brain damage[J].Stroke, 2016, 47(4): 1165-1172.
[12] BALTA S, CELIK T, MIKHAILIDIS D P, et al. Therelation between atherosclerosis and the Neutrophil-Lymphocyte ratio[J]. Clinical and Applied Thrombosis-Hemostasis, 2016, 22(5): 405-411.
[13] MASSIOT N,LAREYRE F, VOURY-PONS A A, etal. High neutrophil to lymphocyte ratio and plateletto lymphocyte ratio are associated with symptomaticinternal carotid artery stenosis[J]. Journal of Stroke &Cerebrovascular Diseases, 2019, 28(1): 76-83.
[14] 国家卫生健康委员会脑卒中防治专家委员会血管超声专业委员会, 中国超声医学工程学会浅表器官及外周血管超声专业委员会, 中国超声医学工程学会颅脑及颈部血管超声专业委员会. 头颈部血管超声若干问题的专家共识( 颈动脉部分)[J]. 中国脑血管病杂志,2020,17(6):346-352, 封3．The Professional Committee of Vascular Ultrasoundof Stroke Prevention and Treatment Expert Committeeof the National Health Commission,the ProfessionalCommittee of Superficial Organ and PeripheralVascular Ultrasound of the Chinese Medical UltrasoundEngineering. Expert consensus on some problems ofcerebral and carotid vascular ultrasonography (Partof carotid) [J]. Chinese Journal of CerebrovascularDiseases, 2020,17 (6): 346-352, cover 3.
[15] SUN Runming, WANG Lixia, GUAN Cuiling, et al.Carotid atherosclerotic plaque features in patients withacute ischemic stroke[J]. World Neurosurgery, 2018,112: e223-e228.
[16] FENG Jifeng, HUANG Ying, ZHAO Qiang, et al.Clinical significance of preoperative neutrophillymphocyte ratio versus platelet lymphocyte ratio inpatients with small cell carcinoma of the esophagus[J].the Scientific World Journal, 2013,2013: 504365.
[17] 陈绍辉, 王伟, 郭锦卿, 等.NLR, PLR 及Lp-PLA2对脑梗死诊断及病情预测的价值[J]. 中国实用神经疾病杂志, 2020, 23(15): 1301-1306.CHEN Shaohui, WANG Wei, GUO Jinqing,et al.Diagnostic performance of NLR,PLR,lipoproteinassociatedphospholipase A2 for neurological deficiencyin pa-tients with cerebral infarction [J]. Chinese Journalof Practical Nervous Diseases, 2020, 23（15）:1301-1306.
[18] Y?KSEL ? ?, K?KL? E, ARSLAN ?, et al.Association of neutrophil/lymphocyte ratio with plaquemorphology in patients with asymptomatic intermediatecarotid artery stenosis[J]. Korean Circulation Journal,2016, 46(5): 699-705.
[19] YUKSEL M, YILDIZ A, OYLUMLU M, et al. Theassociation between platelet/lymphocyte ratio andcoronary artery disease severity[J]. Anatolian Journal ofCardiology, 2015, 15(8): 640-647.
[20] ALTINTAS O, ALTINTAS M O, TASAL A, et al. Therelationship of platelet-to-lymphocyte ratio with clinicaloutcome and final infarct core in acute ischemic strokepatients who have undergone endovascular therapy[J].Neurological Research, 2016, 38(9): 759-765.

相似文献/References:

[1]文关良,剌 梅.脂蛋白相关磷脂酶A2在颈动脉斑块性脑梗死中的临床意义[J].现代检验医学杂志,2017,32(02):117.[doi:10.3969/j.issn.1671-7414.2017.02.032]
　WEN Guan-liang,LA Mei.Clinical Study of LP-PLA2 in Carotid Plaques Cerebral Infarction Patients[J].Journal of Modern Laboratory Medicine,2017,32(01):117.[doi:10.3969/j.issn.1671-7414.2017.02.032]
[2]左 林,赵 佳,姜小建,等.缺血性脑血管病患者血清同型半胱氨酸水平与颈动脉狭窄及斑块稳定性的相关性研究[J].现代检验医学杂志,2017,32(03):11.[doi:10.3969/j.issn.1671-7414.2017.03.003]
　ZUO Lin,ZHAO Jia,JIANG Xiao-jian,et al.Correlation Study between Serum Homocysteine Level and Carotid Artery Stenosis， Plaque Stability in Patients with Ischemic Cerebrovascular Disease[J].Journal of Modern Laboratory Medicine,2017,32(01):11.[doi:10.3969/j.issn.1671-7414.2017.03.003]

备注/Memo

备注/Memo:
基金项目：陕西省重点研发项目（S2020-YF-YBSF-0260）。
作者简介：袁丹（1993-）女，硕士，医师，研究方向：脑血管病，E-mail：1322614075@qq.com。
通讯作者：郭晓敏，女，副主任医师，研究方向：脑血管病，E-mail：26880988@qq.com。
更新日期/Last Update: 1900-01-01