Table_1_Higher Platelet-to-Lymphocyte Ratio Is Associated With Worse Outcomes After Intravenous Thrombolysis in Acute Ischaemic Stroke.docx

Objective: The platelet-to-lymphocyte ratio (PLR) is a new marker of atherosclerotic inflammation and has been identified as a predictive factor in cardiovascular diseases, but its significance in patients with acute ischaemic stroke (AIS) who have undergone intravenous thrombolysis (IVT) is still unknown.Methods: Consecutive patients who were treated with IVT using recombinant tissue plasminogen activator (rtPA) for AIS were included from May 2012 to August 2018. The PLR was calculated according to platelet and lymphocyte counts within 24 h after thrombolysis therapy. Functional outcomes were assessed by the modified Rankin Scale (mRS) at 3 months after thrombolysis. Stroke severity was assessed by National Institutes of Health Stroke Scale (NIHSS) scores. The primary endpoint was an unfavorable outcome (mRS > 2), and the secondary endpoint was death at 3 months.Results: A total of 286 patients were included in the study. The median age was 69.5 (59.0–80.0) years, and 59.1% of patients were men. A total of 120 (42.0%) patients had an unfavorable outcome, and 38 (13.2%) died. Patients with an unfavorable outcome had significantly higher PLR values compared with those with a favorable outcome [172.5 (105.3–239.0) vs. 139 (97.0–194.5), P = 0.008], and the PLR values of the patients who died at 3 months were higher than those of the surviving patients [189.5 (127.5–289.0) vs. 142.0 (98.0–215.5), P = 0.006]. After adjustment for other variables, the PLR was independently associated with the two endpoints: unfavorable outcome (OR 2.220, 95% CI 1.245–3.957, P = 0.007) and death (OR 2.825, 95% CI 1.050–7.601, P = 0.040) at 3 months after thrombolysis. In addition, PLR was correlated with the NIHSS score (R = 0.230, P < 0.001).Conclusions: Higher PLR levels were independently associated with an unfavorable outcome and death at 3 months in AIS patients treated with IVT.

研究目的：血小板与淋巴细胞比率（PLR）作为动脉粥样硬化性炎症的新标志物，已被确认为心血管疾病的风险预测因子，但其对于接受静脉溶栓治疗（IVT）的急性缺血性卒中（AIS）患者的重要性尚不明确。研究方法：从2012年5月至2018年8月，连续纳入使用重组组织型纤溶酶原激活剂（rtPA）进行IVT治疗的AIS患者。根据溶栓治疗24小时内的血小板和淋巴细胞计数计算PLR。通过改良Rankin量表（mRS）在溶栓后3个月评估功能预后。采用美国国立卫生研究院卒中量表（NIHSS）评分评估卒中严重程度。主要终点为不良预后（mRS > 2），次要终点为溶栓后3个月死亡。研究结果：共有286名患者纳入本研究。中位年龄为69.5岁（59.0–80.0岁），其中59.1%为男性。共有120名（42.0%）患者出现不良预后，38名（13.2%）患者死亡。与预后良好组相比，不良预后组患者的PLR值显著升高[172.5（105.3–239.0）比139（97.0–194.5），P = 0.008]，且3个月死亡患者的PLR值高于存活患者[189.5（127.5–289.0）比142.0（98.0–215.5），P = 0.006]。在调整其他变量后，PLR与两个终点独立相关：不良预后（OR 2.220，95% CI 1.245–3.957，P = 0.007）和死亡（OR 2.825，95% CI 1.050–7.601，P = 0.040）。此外，PLR与NIHSS评分呈正相关（R = 0.230，P < 0.001）。研究结论：对于接受IVT治疗的AIS患者，PLR水平升高与不良预后和3个月内的死亡独立相关。