中性粒细胞淋巴细胞比值、淋巴细胞单核细胞比值与症状性颅内动脉粥样硬化性狭窄的关系#br#

目的　探讨中性粒细胞淋巴细胞比值（NLR）、淋巴细胞单核细胞比值（LMR）与症状性颅内动脉粥样硬化性狭窄（sICAS）的关系。方法　采用回顾性分析，将649例sICAS患者依据责任血管狭窄程度分为轻度（58例）、中度（202例）及重度狭窄组（389例）；依据入院时美国国立卫生研究院神经功能缺损评分（NIHSS）分为轻度（504例）及中度缺损组（145例）。收集基线资料、实验室及影像学检查结果。采用Logistic回归探讨影响颅内动脉狭窄程度、神经功能缺损程度的独立影响因素；采用受试者工作特征（ROC）曲线探讨NLR、LMR对神经功能缺损程度的预测价值。结果 （1）女性（OR=3.132，95%CI：1.008~9.732）、入院时高NIHSS评分（OR=1.343，95%CI：1.020~1.769）、高LDL-C（OR=7.341，95%CI：1.609~33.502）、高Hcy（OR=1.320，95%CI：1.069~1.630）是影响sICAS颅内动脉中度狭窄的独立危险因素；高Hcy（OR=1.377，95%CI：1.118~1.697）是影响sICAS颅内动脉重度狭窄的独立危险因素。（2）高Hcy（OR=1.106，95%CI：1.055~1.158）、高NLR（OR=1.612，95%CI：1.340~1.939）是影响sICAS神经功能缺损程度的独立危险因素。（3）ROC曲线结果提示NLR对sICAS患者神经功能缺损程度的预测价值一般（ROC曲线下面积为0.618，95%CI：0.567~0.668，P＜0.01），当NLR为3.5时诊断效能最高；LMR对sICAS患者神经功能缺损程度无预测价值（ROC曲线下面积为0.519，95%CI：0.465~0.573，P＞0.05）。结论　NLR与sICAS神经功能缺损程度有关，NLR升高可能是神经功能缺损程度加重的独立危险因素。

Research on the correlation between neutrophil lymphocyte ratio,lymphocyte monocyteratio and symptomatic intracranial atherosclerotic stenosis#br#

Objective　To investigate the correlation between neutrophil lymphocyte ratio (NLR), lymphocyte monocyte ratio (LMR) and the pathogenesis of symptomatic intracranial atherosclerotic stenosis (sICAS). Methods　By retrospective analysis, a total of 649 sICAS patients were divided into the mild (58 cases), the moderate (202 cases) and the severe stenosis groups (389 cases) according to the severity of responsible artery stenosis. And the patients were divided into the mild neurological defect group (504 cases) and the moderate neurological defect groups (145 cases) according to the National Institutes of Health Stroke Scale score. Baseline data, laboratory and imaging outcomes were collected. Logistic regression analysis was used to investigate the independent risk factors affecting the degree of intracranial artery stenosis and neurological defect. Receiver operating characteristic curve (ROC) was used to explore the efficacy of NLR or LMR in detecting the degree of intracranial artery stenosis and neurological defects. Results　(1) Female (OR=3.132, 95%CI: 1.008-9.732), high NIHSS score at admission (OR=1.343, 95%CI: 1.020-1.769 ), high LDL-C (OR=7.341, 95%CI: 1.609-33.502) and high homocysteine (Hcy, OR=1.320, 95%CI: 1.069-1.630) were independent risk factors for the moderate intracranial arterial stenosis of sICAS. The high Hcy (OR=1.377, 95%CI:1.118-1.697) was an independent risk factor for severeintracranial arterial stenosis of sICAS. (2) The high Hcy (OR=1.106, 95%CI: 1.055-1.158) and high NLR (OR=1.612, 95%CI: 1.340-1.939) were independent risk factors for neurological defect of sICAS. (3) ROC curve indicated that NLR had a low predictive value for the degree of neurological defect in patients (95%CI: 0.567-0.668, P＜0.01) while LMR had no predictive value (95%CI: 0.465-0.573, P＞0.05). (3) When NLR was 3.5, the diagnostic efficiency was the highest. Conclusion　NLR is correlated with the degree of neurological defect of sICAS, and the increased NLR may be an independent risk factor for the aggravation of neurological defect.