European journal of neurology · 2025
Associations of Inflammatory Markers With Neurological Dysfunction and Prognosis in Patients With Progressive Stroke.
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Wang Yingying, Zhang Zhouao, Hang Xiaoyu, Wang Wei
Аннотация
OBJECTIVE: This study aimed to explore the associations between inflammatory markers and the severity of early neurological dysfunction and prognosis in patients with progressive stroke (PS) and evaluated the predictive value of inflammatory markers for PS.
METHODS: Among 711 acute ischemic stroke (AIS) patients, 210 patients with PS and 501 patients without PS were included. Six inflammatory markers, including neutrophil to lymphocyte ratio (NLR), platelet to lymphocyte ratio (PLR), lymphocyte to monocyte ratio (LMR), systemic immune-inflammation index (SII), systemic inflammatory response index (SIRI), and pan-immune-inflammation value (PIV), were measured and compared between two groups. Correlation analysis was used to analyze the correlation between inflammatory markers and early neurological dysfunction in patients with PS. Univariate and multivariate regression analyses were applied to screen the factors for the prognosis of PS patients. The receiver operating characteristic (ROC) curve was utilized to evaluate the predictive value for the prognosis of PS patients.
RESULTS: Elevated levels of NLR, LMR, SII, and PIV were observed in PS patients. Correlation analysis revealed positive correlations between NLR, PLR, SII, SIRI, PIV, and early neurological deficits, while LMR showed a negative correlation in PS patients. Multivariate analysis identified LMR and the National Institutes of Health Stroke Score (NIHSS) as independent risk factors for poor outcome of PS patients. The predictive value of LMR alone was limited (AUC = 0.59), but combining it with NIHSS improved predictive accuracy (AUC = 0.73) (p < 0.05).
CONCLUSION: These findings suggest that inflammatory markers, particularly LMR, should be considered in PS management, and their combination with NIHSS enhances outcome prediction.
METHODS: Among 711 acute ischemic stroke (AIS) patients, 210 patients with PS and 501 patients without PS were included. Six inflammatory markers, including neutrophil to lymphocyte ratio (NLR), platelet to lymphocyte ratio (PLR), lymphocyte to monocyte ratio (LMR), systemic immune-inflammation index (SII), systemic inflammatory response index (SIRI), and pan-immune-inflammation value (PIV), were measured and compared between two groups. Correlation analysis was used to analyze the correlation between inflammatory markers and early neurological dysfunction in patients with PS. Univariate and multivariate regression analyses were applied to screen the factors for the prognosis of PS patients. The receiver operating characteristic (ROC) curve was utilized to evaluate the predictive value for the prognosis of PS patients.
RESULTS: Elevated levels of NLR, LMR, SII, and PIV were observed in PS patients. Correlation analysis revealed positive correlations between NLR, PLR, SII, SIRI, PIV, and early neurological deficits, while LMR showed a negative correlation in PS patients. Multivariate analysis identified LMR and the National Institutes of Health Stroke Score (NIHSS) as independent risk factors for poor outcome of PS patients. The predictive value of LMR alone was limited (AUC = 0.59), but combining it with NIHSS improved predictive accuracy (AUC = 0.73) (p < 0.05).
CONCLUSION: These findings suggest that inflammatory markers, particularly LMR, should be considered in PS management, and their combination with NIHSS enhances outcome prediction.