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Dynamic Neutrophil–Lymphocyte Ratios Predict Short-term Prognostic Outcome of Thrombolysis in Patients with Acute Ischemic Stroke

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Abstract

Aim

The main purpose of this study was to investigate the dynamic changes of neutrophils-lymphocytes ratios (NLRs) in patients with acute ischemic stroke (AIS) and their relationships with 3-month prognostic outcomes.

Methods

Two hundred ninety-one patients with AIS were included in this study, followed up for 3 months. At admission, 1 and 7 days after recombinant tissue plasminogen activator (r-tPA) injection, blood samples were obtained. Outcome events included excellent outcome, good outcome, and death defined as modified Rankin Scale (mRS) scores of 0–1, 0–2, and 6 respectively.

Results

NLRs measured in admission and 7 days after r-tPA treatment were associated with prognosis outcome after 3 months. Twenty-four-hour NLR is an excellent indicator in forecasting (excellent outcome’s the areas under the curve (AUC) = 0.725; good outcome AUC = 0.742; death AUC = 0.759). In addition, we were surprised to find that dynamic increase in NLR within 24 h is significantly related to excellent and good outcomes.

Conclusions

Twenty-four-hour NLR is related to the severity of AIS and poor prognosis, which can help early risk stratification.

Significance

We can predict the prognosis of AIS more accurately. Compared with previous studies, our study has shown the dynamic changes of NLR and its relationship with NIHSS and multiple prognostic.

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Acknowledgements

We sincerely thank the participating hospitals, patients, their families and colleagues who have provided valuable suggestions for this study.

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Author notes

  1. Co-first author: Yiyun Weng, Jingyu Hu and Junli Ren

Authors and Affiliations

  1. Department of Neurology, The First Affiliated Hospital of Wenzhou Medical University, Wenzhou, China

    Yiyun Weng

  2. Department of Neurology, The Third Affiliated Hospital of Wenzhou Medical University, Zhejiang, 325000, Wenzhou, China

    Jingyu Hu, Junli Ren, Honghao Huang, Chenguang Yang, Jiamin Shen, Wenjing Pan, Fangyue Sun, Haojie Qiu, Yufan Gao, Shengqi Li, Xuerong Huang & Guangyong Chen

  3. School of the First Clinical Medical Sciences, Wenzhou Medical University, Wenzhou, China

    Jingyu Hu, Junli Ren, Honghao Huang, Chenguang Yang, Jiamin Shen, Wenjing Pan, Fangyue Sun, Haojie Qiu, Yufan Gao & Shengqi Li

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  1. Yiyun Weng
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Correspondence to Xuerong Huang or Guangyong Chen.

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Weng, Y., Hu, J., Ren, J. et al. Dynamic Neutrophil–Lymphocyte Ratios Predict Short-term Prognostic Outcome of Thrombolysis in Patients with Acute Ischemic Stroke. Neurotox Res 39, 1678–1687 (2021). https://doi.org/10.1007/s12640-021-00382-6

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  • DOI: https://doi.org/10.1007/s12640-021-00382-6

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