白细胞亚型与缺血性脑卒中预后关系的研究进展
|
摘要
脑卒中是一种高致死率及高致残率疾病,其中约70%为缺血性卒中,卒中预后与患者生存质量息息相关,入院时对卒中预后的预测可指导临床治疗、护理及康复方案的制定。白细胞是人体内主要的介导免疫反应的血细胞,分为中性粒细胞、淋巴细胞及嗜酸性粒细胞等,其中中性粒细胞与淋巴细胞共占60%～90%。研究表明,中性粒细胞计数、淋巴细胞计数及中性粒细胞/淋巴细胞比值均与缺血性卒中短期预后密切相关。本文对中性粒细胞及淋巴细胞与急性缺血性卒中短期预后的关系及其机制进行综述,以指导临床尽早积极干预,改善不良预后。
Stroke is known as its high fatality and high morbidity, approximately 70% of which are cerebral infarction.The prognosis after stroke is closely related to the quality of life of patients. The prediction of post-stroke prognosis at admission can guide clinical treatment, nursing and rehabilitation programs. White blood cells are the main blood cells that mediate the immune response in human body, they are divided into neutrophils, lymphocytes and eosinophils and so on. The neutrophils and lymphocytes account for 60%-90%. Studies have shown that neutrophil counts, lymphocyte counts, and neutrophil/lymphocyte ratios are closely related to short-term prognosis of ischemic stroke. This article reviews the relationship between neutrophils and lymphocytes and short-term prognosis of acute ischemic stroke and its mechanism to guide early clinical intervention and improve poor prognosis.
Stroke is known as its high fatality and high morbidity, approximately 70% of which are cerebral infarction.The prognosis after stroke is closely related to the quality of life of patients. The prediction of post-stroke prognosis at admission can guide clinical treatment, nursing and rehabilitation programs. White blood cells are the main blood cells that mediate the immune response in human body, they are divided into neutrophils, lymphocytes and eosinophils and so on. The neutrophils and lymphocytes account for 60%-90%. Studies have shown that neutrophil counts, lymphocyte counts, and neutrophil/lymphocyte ratios are closely related to short-term prognosis of ischemic stroke. This article reviews the relationship between neutrophils and lymphocytes and short-term prognosis of acute ischemic stroke and its mechanism to guide early clinical intervention and improve poor prognosis.
引文
[1]Price CJ,Menon DK,Peters AM,et al.Cerebral neutrophil recruitment,histology,and outcome in acute ischemic stroke:an imaging-based study[J].Stroke,2004,35(7):1659-1664.
[2]Furlan JC,Vergouwen MD,Fang J,et al.White blood cell count is an independent predictor of outcomes after acute ischaemic stroke[J].Eur J Neurol,2014,21(2):215-222.
[3]Fang YN,Tong MS,Sung PH,et al.Higher neutrophil counts and neutrophil-to-lymphocyte ratio predict prognostic outcomes in patients after non-atrial fibrillation-caused ischemic stroke[J].Biomed J,2017,40(3):154-162.
[4]Pagram H,Bivard A,Lincz LF,et al.Peripheral immune cell counts and advanced imaging as biomarkers of stroke outcome[J].Cerebrovasc Dis Extra,2016,6(3):120-128.
[5]Buck BH,Liebeskind DS,Saver JL,et al.Early neutrophilia is associated with volume of ischemic tissue in acute stroke[J].Stroke,2008,39(2):355-360.
[6]Kumar AD,Boehme AK,Siegler JE,et al.Leukocytosis in patients with neurologic deterioration after acute ischemic stroke is associated with poor outcomes[J].J Stroke Cerebrovasc Dis,2013,22(7):e111-e117.
[7]Jickling GC,Liu D,Ander BP,et al.Targeting neutrophils in ischemic stroke:translational insights from experimental studies[J].J Cereb Blood Flow Metab,2015,35(6):888-901.
[8]Valles J,Lago A,Santos MT,et al.Neutrophil extra cellular traps are increased in patients with acute ischemic stroke:prognostic significance[J].Thromb Haemost,2017,117(10):1919-1929.
[9]Dziedzic T.Systemic inflammation as a therapeutic target in acute ischemic stroke[J].Expert Rev Neurother,2015,15(5):523-531.
[10]Krams M,Lees KR,Hacke W,et al.Acute stroke therapy by inhibition of neutrophils(ASTIN):an adaptive dose-response study of UK-279,276 in acute ischemic stroke[J].Stroke,2003,34(11):2543-2548.
[11]Nam KW,Kim TJ,Lee JS,et al.High neutrophil-to-lymphocyte ratio predicts stroke-associated pneumonia[J].Stroke,2018,49(11):e323-e324..
[12]Kim J,Song TJ,Park JH,et al.Different prognostic value of white blood cell subtypes in patients with acute cerebral infarction[J].Atherosclerosis,2012,222(2):464-467.
[13]Gill D,Sivakumaran P,Aravind A,et al.Temporal trends in the levels of peripherally circulating leukocyte subtypes in the hours after ischemic stroke[J].J Stroke Cerebrovasc Dis,2018,27(1):198-202.
[14]Kim JY,Kawabori M,Yenari MA.Innate inflammatory responses in stroke:mechanisms and potential therapeutic targets[J].Curr Med Chem,2014,21(18):2076-2097.
[15]Gokhan S,Ozhasenekler A,Mansur Durgun H,et al.Neutrophil lymphocyte ratios in stroke subtypes and transient ischemic attack[J].Eur Rev Med Pharmacol Sci,2013,17(5):653-657.
[16]Tokgoz S,Keskin S,Kayrak M,et al.Is neutrophil/lymphocyte ratio predict to short-term mortality in acute cerebral infarct independently from infarct volume?[J].J Stroke Cerebrovasc Dis,2014,23(8):2163-2168.
[17]Celikbilek A,Ismailogullari S,Zararsiz G.Neutrophil to lymphocyte ratio predicts poor prognosis in ischemic cerebrovascular disease[J].J Clin Lab Anal,2014,28(1):27-31.
[18]Qun S,Tang Y,Sun J,et al.Neutrophil-to-lymphocyte ratio predicts 3-month outcome of acute ischemic stroke[J].Neurotox Res,2017,31(3):444-452.
[19]Brooks SD,Spears C,Cummings C,et al.Admission neutrophil-lymphocyte ratio predicts 90 day outcome after endovascular stroke therapy[J].J Neurointerv Surg,2014,6(8):578-583.
[20]Maestrini I,Strbian D,Gautier S,et al.Higher neutrophil counts before thrombolysis for cerebral ischemia predict worse outcomes[J].Neurology,2015,85(16):1408-1416.
[21]Zhang J,Ren Q,Song Y,et al.Prognostic role of neutrophil-lymphocyte ratio in patients with acute ischemic stroke[J].Medicine(Baltimore),2017,96(45):e8624.
[22]Xue J,Huang W,Chen X,et al.Neutrophil-to-lymphocyte ratio is a prognostic marker in acute ischemic stroke[J].JStroke Cerebrovasc Dis,2017,26(3):650-657.
[23]Fan L,Gui L,Chai EQ,et al.Routine hematological parameters are associated with short-and long-term prognosis of patients with ischemic stroke[J].J Clin Lab Anal,2018,32(2):22 244.
[24]Fowler AJ,Agha RA.Neutrophil/lymphocyte ratio is related to the severity of coronary artery disease and clinical outcome in patients undergoing angiography---the growing versatility of NLR[J].Atherosclerosis,2013,228(1):44-45.
[25]Ertas G,Sonmez O,Turfan M,et al.Neutrophil/lymphocyte ratio is associated with thromboembolic stroke in patients with non-valvular atrial fibrillation[J].J Neurol Sci,2013,324(1-2):49-52.
[26]Spite M,Serhan CN.Novel lipid mediators promote resolution of acute inflammation:impact of aspirin and statins[J].Circ Res,2010,107(10):1170-1184.
[27]Nardi K,Milia P,Eusebi P,et al.Admission leukocytosis in acute cerebral ischemia:influence on early outcome[J].JStroke Cerebrovasc Dis,2012,21(8):819-824.
[2]Furlan JC,Vergouwen MD,Fang J,et al.White blood cell count is an independent predictor of outcomes after acute ischaemic stroke[J].Eur J Neurol,2014,21(2):215-222.
[3]Fang YN,Tong MS,Sung PH,et al.Higher neutrophil counts and neutrophil-to-lymphocyte ratio predict prognostic outcomes in patients after non-atrial fibrillation-caused ischemic stroke[J].Biomed J,2017,40(3):154-162.
[4]Pagram H,Bivard A,Lincz LF,et al.Peripheral immune cell counts and advanced imaging as biomarkers of stroke outcome[J].Cerebrovasc Dis Extra,2016,6(3):120-128.
[5]Buck BH,Liebeskind DS,Saver JL,et al.Early neutrophilia is associated with volume of ischemic tissue in acute stroke[J].Stroke,2008,39(2):355-360.
[6]Kumar AD,Boehme AK,Siegler JE,et al.Leukocytosis in patients with neurologic deterioration after acute ischemic stroke is associated with poor outcomes[J].J Stroke Cerebrovasc Dis,2013,22(7):e111-e117.
[7]Jickling GC,Liu D,Ander BP,et al.Targeting neutrophils in ischemic stroke:translational insights from experimental studies[J].J Cereb Blood Flow Metab,2015,35(6):888-901.
[8]Valles J,Lago A,Santos MT,et al.Neutrophil extra cellular traps are increased in patients with acute ischemic stroke:prognostic significance[J].Thromb Haemost,2017,117(10):1919-1929.
[9]Dziedzic T.Systemic inflammation as a therapeutic target in acute ischemic stroke[J].Expert Rev Neurother,2015,15(5):523-531.
[10]Krams M,Lees KR,Hacke W,et al.Acute stroke therapy by inhibition of neutrophils(ASTIN):an adaptive dose-response study of UK-279,276 in acute ischemic stroke[J].Stroke,2003,34(11):2543-2548.
[11]Nam KW,Kim TJ,Lee JS,et al.High neutrophil-to-lymphocyte ratio predicts stroke-associated pneumonia[J].Stroke,2018,49(11):e323-e324..
[12]Kim J,Song TJ,Park JH,et al.Different prognostic value of white blood cell subtypes in patients with acute cerebral infarction[J].Atherosclerosis,2012,222(2):464-467.
[13]Gill D,Sivakumaran P,Aravind A,et al.Temporal trends in the levels of peripherally circulating leukocyte subtypes in the hours after ischemic stroke[J].J Stroke Cerebrovasc Dis,2018,27(1):198-202.
[14]Kim JY,Kawabori M,Yenari MA.Innate inflammatory responses in stroke:mechanisms and potential therapeutic targets[J].Curr Med Chem,2014,21(18):2076-2097.
[15]Gokhan S,Ozhasenekler A,Mansur Durgun H,et al.Neutrophil lymphocyte ratios in stroke subtypes and transient ischemic attack[J].Eur Rev Med Pharmacol Sci,2013,17(5):653-657.
[16]Tokgoz S,Keskin S,Kayrak M,et al.Is neutrophil/lymphocyte ratio predict to short-term mortality in acute cerebral infarct independently from infarct volume?[J].J Stroke Cerebrovasc Dis,2014,23(8):2163-2168.
[17]Celikbilek A,Ismailogullari S,Zararsiz G.Neutrophil to lymphocyte ratio predicts poor prognosis in ischemic cerebrovascular disease[J].J Clin Lab Anal,2014,28(1):27-31.
[18]Qun S,Tang Y,Sun J,et al.Neutrophil-to-lymphocyte ratio predicts 3-month outcome of acute ischemic stroke[J].Neurotox Res,2017,31(3):444-452.
[19]Brooks SD,Spears C,Cummings C,et al.Admission neutrophil-lymphocyte ratio predicts 90 day outcome after endovascular stroke therapy[J].J Neurointerv Surg,2014,6(8):578-583.
[20]Maestrini I,Strbian D,Gautier S,et al.Higher neutrophil counts before thrombolysis for cerebral ischemia predict worse outcomes[J].Neurology,2015,85(16):1408-1416.
[21]Zhang J,Ren Q,Song Y,et al.Prognostic role of neutrophil-lymphocyte ratio in patients with acute ischemic stroke[J].Medicine(Baltimore),2017,96(45):e8624.
[22]Xue J,Huang W,Chen X,et al.Neutrophil-to-lymphocyte ratio is a prognostic marker in acute ischemic stroke[J].JStroke Cerebrovasc Dis,2017,26(3):650-657.
[23]Fan L,Gui L,Chai EQ,et al.Routine hematological parameters are associated with short-and long-term prognosis of patients with ischemic stroke[J].J Clin Lab Anal,2018,32(2):22 244.
[24]Fowler AJ,Agha RA.Neutrophil/lymphocyte ratio is related to the severity of coronary artery disease and clinical outcome in patients undergoing angiography---the growing versatility of NLR[J].Atherosclerosis,2013,228(1):44-45.
[25]Ertas G,Sonmez O,Turfan M,et al.Neutrophil/lymphocyte ratio is associated with thromboembolic stroke in patients with non-valvular atrial fibrillation[J].J Neurol Sci,2013,324(1-2):49-52.
[26]Spite M,Serhan CN.Novel lipid mediators promote resolution of acute inflammation:impact of aspirin and statins[J].Circ Res,2010,107(10):1170-1184.
[27]Nardi K,Milia P,Eusebi P,et al.Admission leukocytosis in acute cerebral ischemia:influence on early outcome[J].JStroke Cerebrovasc Dis,2012,21(8):819-824.