Tỷ bạch cầu đa nhân/bạch cầu lympho máu trong tiên lượng bệnh nhân nhồi máu não cấp

Abstract

Background: The neutrophil – lymphocyte ratio (NLR) reflects the balance between the innate immune response (neutrophils) and adaptive immunity (lymphocytes). Recently, several studies have demonstrated that high NLR is an independent predictor of poor clinical outcome in stroke patients. However, other studies have shown that this ratio has no clear effect on mortality. We investigated the relationship between NLR and severity through the Glasgow and NIHSS scales in acute ischemic stroke (AIS) patients. Methods: A study of 115 patients diagnosed with AIS at Hue University Hospital of Medicine and Pharmacy and Hue Central Hospital from February, 2022 to February, 2023. In this study, we use questionnaire to collect essential research information. NLR, Glasgow and NIHSS scales were measured at the time of admission. Results: We included 115 patients with AIS. Average of age is 70,6±11,9 years, male/female ratio as 1,4:1. NLR is moderately negatively correlated with Glasgow (r=-0.354, p<0.001) and moderately positively correlated with NIHSS (r=0.465, p<0.001). The accuracy in predicting the possibility of severe or higher consciousness disorder on the Glasgow scale of NLR is not good (AUC=0.641, p>0.05). The accuracy in predicting clinical severity on the NIHSS scale of NLR is quite good (AUC=0.767; p=0.003 <0.05). The NLR cut-off point at admission is 5,1128 with a sensitivity of 75.0% and a specificity of 78.6%. Conclusion: NLR has been shown to be associated with severity according to the Glasgow and NIHSS scales and have high sensitivity and specificity in helping to identify severe patients according to the NIHSS scale in patients with AIS.