AnNa Ying1, YaNi Cheng1, YanYan Lin1, JunRu Yu2, XiaoYun Wu3, YuanShao Lin4. 1. Department of Neurology, First Affiliated Hospital of Wenzhou Medical University, Wenzhou, 325000, China. 2. Department of Neurology, Third Affiliated Hospital of Wenzhou Medical University, Wenzhou, 325000, China. 3. Department of Rehabilitation, First Affiliated Hospital of Wenzhou Medical University, Wenzhou, 325000, China. 4. Department of Neurology, First Affiliated Hospital of Wenzhou Medical University, Wenzhou, 325000, China. linyuanshao@wmu.edu.cn.
Abstract
BACKGROUND: The higher level of neutrophil on admission has been reported to predict worse 3-month outcomes in ischemic stroke patients. Our study was to explore the dynamic changes of neutrophil and lymphocyte after r-tPA thrombolysis of ischemic stroke and the relationship with parenchymal hemorrhage (PH) and 3-month function outcome. METHODS: A total of 208 acute ischemic stroke (AIS) patients with intravenous thrombolysis were included and then received 3-month follow-up in the present study. Blood samples for neutrophil and lymphocyte counts were obtained on admission, at 24 h and at 7 days after r-tPA infusion. The associations of increase in neutrophil, lymphocyte, and neutrophil to lymphocyte ratio (NLR) with PH or 3-month poor outcome were examined by logistic regression. RESULTS: Increasing trends in the neutrophil and NLR were observed in AIS patients after r-tPA treatment. Increased level of neutrophil at 24 h after r-tPA infusion but not that on admission was associated with PH (OR = 2.86, P = 0.029) and 3-month poorer functional outcomes (OR = 2.67, P = 0.009). Moreover, patients were divided into four groups according to the percent change in neutrophil within 24 h following r-tPA treatment, and we found that there was a trend of incremental OR when compared higher increase group with lower ones. CONCLUSIONS: Dynamic increase in neutrophil and NLR after stroke may predict PH and 3-month poor outcome in AIS patients receiving r-tPA treatment. Therefore, neutrophil and NLR may serve as activity markers for PH and 3-month poor prognosis in AIS patients with intravenous thrombolysis.
BACKGROUND: The higher level of neutrophil on admission has been reported to predict worse 3-month outcomes in ischemic strokepatients. Our study was to explore the dynamic changes of neutrophil and lymphocyte after r-tPA thrombolysis of ischemic stroke and the relationship with parenchymal hemorrhage (PH) and 3-month function outcome. METHODS: A total of 208 acute ischemic stroke (AIS) patients with intravenous thrombolysis were included and then received 3-month follow-up in the present study. Blood samples for neutrophil and lymphocyte counts were obtained on admission, at 24 h and at 7 days after r-tPA infusion. The associations of increase in neutrophil, lymphocyte, and neutrophil to lymphocyte ratio (NLR) with PH or 3-month poor outcome were examined by logistic regression. RESULTS: Increasing trends in the neutrophil and NLR were observed in AIS patients after r-tPA treatment. Increased level of neutrophil at 24 h after r-tPA infusion but not that on admission was associated with PH (OR = 2.86, P = 0.029) and 3-month poorer functional outcomes (OR = 2.67, P = 0.009). Moreover, patients were divided into four groups according to the percent change in neutrophil within 24 h following r-tPA treatment, and we found that there was a trend of incremental OR when compared higher increase group with lower ones. CONCLUSIONS: Dynamic increase in neutrophil and NLR after stroke may predict PH and 3-month poor outcome in AIS patients receiving r-tPA treatment. Therefore, neutrophil and NLR may serve as activity markers for PH and 3-month poor prognosis in AIS patients with intravenous thrombolysis.
Authors: Erwin Chiquete; Amado Jiménez-Ruiz; Miguel García-Grimshaw; Rogelio Domínguez-Moreno; Elizabeth Rodríguez-Perea; Paola Trejo-Romero; Eduardo Ruiz-Ruiz; Valeria Sandoval-Rodríguez; Juan José Gómez-Piña; Guillermo Ramírez-García; Ana Ochoa-Guzmán; Liz Toapanta-Yanchapaxi; Fernando Flores-Silva; José Luis Ruiz-Sandoval; Carlos Cantú-Brito Journal: Neurol Sci Date: 2020-11-25 Impact factor: 3.307