中性粒细胞与淋巴细胞比值作为急性缺血性卒中卒中相关性肺炎风险的补充标志物
Neutrophil-to-Lymphocyte Ratio as a Complementary Marker for Stroke-Associated Pneumonia Risk in Acute Ischemic Stroke.
文献信息
| PMID | 42724591 |
|---|---|
| 原文 | 在 PubMed 查看原文 ↗ |
| 发表日期 | 2026 |
| 作者 | Lisda Amalia |
| 作者单位 | Department of Neurology, Medical Faculty, Universitas Padjadjaran/RSUP Dr. Hasan Sadikin, Bandung, Indonesia. |
| 期刊 | Stroke research and treatment |
| SCI 分区 | Q3 |
| IF | 2 |
| 研究类型 | 临床研究 · 临床 |
| 所属专科 | 咽喉科 |
中文摘要
背景： 卒中后最常见的非神经性并发症之一是卒中相关性肺炎（SAP），它显著增加发病率和死亡率。早期识别与SAP相关的因素至关重要，其中中性粒细胞与淋巴细胞比值（NLR）作为一种实用且易获取的全身炎症生物标志物，正逐渐用于临床筛查。本研究旨在确定SAP的发生率，并分析影响急性缺血性卒中患者SAP发生的生物学和机械性因素。
方法： 这项回顾性队列研究连续纳入了急性缺血性卒中患者，其数据通过病历回顾提取，包括入院时的NLR。进行双变量分析以识别与SAP相关的因素，随后进行多变量逻辑回归以确定独立预测因素。使用受试者工作特征（ROC）曲线分析评估NLR的诊断性能。
结果： 在615例急性缺血性卒中患者中，SAP的发生率为19.7%。多变量逻辑回归确定NLR > 5.21、吞咽困难、NIHSS > 8、年龄 > 60岁和营养风险与SAP独立相关。NLR > 5.21具有最大的调整比值比（aOR 11.43，95% CI 5.74-18.93）。在ROC分析中，NLR显示出良好的区分度（AUC 0.78），尽管NIHSS显示出更高的区分度（AUC 0.84）。
结论： NLR > 5.21与SAP独立相关，并显示出良好的区分性能。然而，NIHSS显示出更优的区分度，表明NLR应被视为补充生物标志物而非独立预测因子。
英文摘要
BACKGROUND: One of the most common nonneurological complications after stroke is stroke-associated pneumonia (SAP), which significantly increases morbidity and mortality. Early identification of factors associated with SAP is essential, with the neutrophil-to-lymphocyte ratio (NLR) emerging as a practical and accessible systemic inflammatory biomarker for clinical screening. This study is aimed at determining the incidence of SAP and analyzing the biological and mechanical factors influencing its occurrence in patients with acute ischemic stroke.
METHOD: This retrospective cohort study included consecutive patients with acute ischemic stroke whose data were extracted from medical record reviews, including admission NLR. Bivariate analyses were performed to identify factors associated with SAP, followed by multivariable logistic regression to determine independent predictors. The diagnostic performance of NLR was evaluated using receiver operating characteristic (ROC) curve analysis.
RESULTS: The incidence of SAP among 615 acute ischemic stroke patients was 19.7%. Multivariable logistic regression identified NLR > 5.21, dysphagia, NIHSS > 8, age > 60 years, and nutritional risk as independently associated with SAP. NLR > 5.21 had the largest adjusted odds ratio (aOR 11.43, 95% CI 5.74-18.93). In ROC analysis, NLR demonstrated good discrimination (AUC 0.78), although NIHSS showed higher discrimination (AUC 0.84).
CONCLUSIONS: NLR > 5.21 was independently associated with SAP and demonstrated good discriminatory performance. However, NIHSS showed superior discrimination, indicating that NLR should be considered as a complementary biomarker rather than a standalone predictor.