PDF(Pubmed)
Abstract：
OBJECTIVE: Immune and inflammatory response plays a central role in the clinical outcomes of stroke. This study is aimed to explore the clinical significance of the new inflammation index named pan-immune-inflammation value (PIV) in patients with acute ischemic stroke (AIS) after intravenous thrombolysis therapy (IVT).
METHODS: Data were collected from 717 patients who received IVT at the First Affiliated Hospital of Soochow University. Baseline data were collected before intravenous thrombolysis. Multivariate logistic regression analysis was used to assess the association between PIV and 3 months clinical outcome after intravenous thrombolysis. We also used receiver operating characteristic (ROC) curves analysis to assess the discriminative ability of PIV, platelet to lymphocyte ratio (PLR), neutrophil to lymphocyte ratio (NLR), and systemic immune-inflammation index (SII) in predicting 3 months poor outcome.
RESULTS: Of 717 patients, 182 (25.4%) patients had poor outcomes at 3 months. Patients with 3 months of poor outcome had significantly higher PIV levels compared to those with favorable outcomes [316.32 (187.42-585.67) vs. 223.80 (131.76-394.97), p < 0.001)]. After adjusting for potential confounders, the risk of 3 months of poor outcome was significantly higher among patients whose PIV fell in the third quartile (244.21-434.49) and the fourth quartile (> 434.49) than those in the first quartile (< 139.93) (OR = 1.905, 95% CI: 1.040-3.489; OR = 2.229, 95%CI: 1.229-4.044). The area under the ROC curve of PIV to predict 3 months of poor outcome was 0.607 (95%CI: 0.560-0.654; p < 0.001). The optimal cut-off values of PIV were 283.84 (59% sensitivity and 62% specificity).
CONCLUSIONS: The higher levels of PIV were independently associated with 3 months of poor outcomes in AIS patients receiving IVT. PIV like other inflammatory factors (PLR, NLR, and SII), can also predict adverse outcomes after IVT in AIS patients.
METHODS: Data were collected from 717 patients who received IVT at the First Affiliated Hospital of Soochow University. Baseline data were collected before intravenous thrombolysis. Multivariate logistic regression analysis was used to assess the association between PIV and 3 months clinical outcome after intravenous thrombolysis. We also used receiver operating characteristic (ROC) curves analysis to assess the discriminative ability of PIV, platelet to lymphocyte ratio (PLR), neutrophil to lymphocyte ratio (NLR), and systemic immune-inflammation index (SII) in predicting 3 months poor outcome.
RESULTS: Of 717 patients, 182 (25.4%) patients had poor outcomes at 3 months. Patients with 3 months of poor outcome had significantly higher PIV levels compared to those with favorable outcomes [316.32 (187.42-585.67) vs. 223.80 (131.76-394.97), p < 0.001)]. After adjusting for potential confounders, the risk of 3 months of poor outcome was significantly higher among patients whose PIV fell in the third quartile (244.21-434.49) and the fourth quartile (> 434.49) than those in the first quartile (< 139.93) (OR = 1.905, 95% CI: 1.040-3.489; OR = 2.229, 95%CI: 1.229-4.044). The area under the ROC curve of PIV to predict 3 months of poor outcome was 0.607 (95%CI: 0.560-0.654; p < 0.001). The optimal cut-off values of PIV were 283.84 (59% sensitivity and 62% specificity).
CONCLUSIONS: The higher levels of PIV were independently associated with 3 months of poor outcomes in AIS patients receiving IVT. PIV like other inflammatory factors (PLR, NLR, and SII), can also predict adverse outcomes after IVT in AIS patients.
摘要：
目的：免疫和炎症反应在卒中的临床结局中起重要作用。本研究旨在探讨新的炎症指标泛免疫-炎症值(PIV)在急性缺血性脑卒中(AIS)患者静脉溶栓(IVT)后的临床意义。
方法：收集了苏州大学附属第一医院接受IVT的717例患者的数据。在静脉溶栓前收集基线数据。采用多因素logistic回归分析评估PIV与静脉溶栓后3个月临床结局之间的关系。我们还使用受试者工作特征（ROC）曲线分析来评估PIV的辨别能力，血小板与淋巴细胞比率（PLR），中性粒细胞与淋巴细胞比率（NLR），和全身免疫炎症指数（SII）预测3个月的不良结局。
结果：在717名患者中，182例（25.4%）患者在3个月时预后较差。与具有良好结局的患者相比，具有3个月不良结局的患者的PIV水平明显更高[316.32（187.42-585.67）vs.223.80(131.76-394.97),p<0.001)。在调整了潜在的混杂因素后，PIV在第3四分位数(244.21~434.49)和第4四分位数(>434.49)下降的患者中,3个月不良结局的风险显著高于第1四分位数(<139.93)(OR=1.905,95%CI:1.040~3.489;OR=2.229,95CI:1.229~4.044).PIV预测3个月不良预后的ROC曲线下面积为0.607(95CI:0.560-0.653;p<0.001)。PIV的最佳临界值为283.84(59%的灵敏度和62%的特异性)。
结论：在接受IVT的AIS患者中，较高的PIV水平与3个月的不良预后独立相关。PIV像其他炎症因子（PLR，NLR,andSII),还可以预测AIS患者IVT后的不良结局。
方法：收集了苏州大学附属第一医院接受IVT的717例患者的数据。在静脉溶栓前收集基线数据。采用多因素logistic回归分析评估PIV与静脉溶栓后3个月临床结局之间的关系。我们还使用受试者工作特征（ROC）曲线分析来评估PIV的辨别能力，血小板与淋巴细胞比率（PLR），中性粒细胞与淋巴细胞比率（NLR），和全身免疫炎症指数（SII）预测3个月的不良结局。
结果：在717名患者中，182例（25.4%）患者在3个月时预后较差。与具有良好结局的患者相比，具有3个月不良结局的患者的PIV水平明显更高[316.32（187.42-585.67）vs.223.80(131.76-394.97),p<0.001)。在调整了潜在的混杂因素后，PIV在第3四分位数(244.21~434.49)和第4四分位数(>434.49)下降的患者中,3个月不良结局的风险显著高于第1四分位数(<139.93)(OR=1.905,95%CI:1.040~3.489;OR=2.229,95CI:1.229~4.044).PIV预测3个月不良预后的ROC曲线下面积为0.607(95CI:0.560-0.653;p<0.001)。PIV的最佳临界值为283.84(59%的灵敏度和62%的特异性)。
结论：在接受IVT的AIS患者中，较高的PIV水平与3个月的不良预后独立相关。PIV像其他炎症因子（PLR，NLR,andSII),还可以预测AIS患者IVT后的不良结局。
