背景和目的在全球范围内,中风是导致残疾和死亡率的主要因素之一。缺血性卒中病理生理学的最新进展强调了免疫系统在卒中相关损伤和神经保护中的重要作用。本文研究了血红蛋白水平与白细胞计数之间的关系。材料与方法2019年1月1日至2022年4月1日,纳入所有在KanuniSultanSüleyman训练研究医院急诊科确诊为急性缺血性卒中并在卒中发病4.5小时内接受静脉注射重组组织型纤溶酶原激活剂(r-tPA)治疗的18岁及以上患者。性别,年龄,出现症状,投诉,美国国立卫生研究院卒中量表(NIHSS)评分,中风影响区域,以及白细胞,中性粒细胞,血小板,嗜酸性粒细胞,淋巴细胞,记录和血红蛋白水平,并在死亡率和幸存者组之间进行比较.结果共61人,包括33名男性和28名女性,包括在研究中。随访期间死亡4例。入院时症状的平均持续时间为86.23±56.37分钟。患者的平均NIHSS评分为9.16±3.88(最小:4,最大:18)。年龄和症状持续时间之间存在统计学上显著的正相关(p<0.002,r:0.391)。嗜酸性粒细胞计数与NIHSS评分(p<0.012,r:-0.321)之间以及嗜酸性粒细胞计数与症状持续时间(p<0.042,r:-0.261)之间存在统计学上的显着负相关。血红蛋白水平与死亡率呈负相关(p<0.013,r:-0.318)。嗜酸性粒细胞与中性粒细胞比率(ENR)与NIHSS评分(p<0.017,r:-0.305)之间以及ENR与症状持续时间(p<0.034,r:-0.271)之间观察到统计学上显着的负相关。在逻辑回归模型中,血红蛋白是死亡率的重要预测因子(p<0.05,CI:0.253-0.942)。血红蛋白每增加一个单位,死亡率降低了0.488倍.结论某些血细胞类型(中性粒细胞,嗜酸性粒细胞,和淋巴细胞)在确定中风预后中起积极作用。对白细胞类型的作用的详细解释为“免疫调节”奠定了基础,“这可能是未来中风患者的一种有希望的新型治疗方式。
Background and aim Stroke ranks among the primary contributors to disability and mortality on a global scale. Recent advances in ischemic stroke pathophysiology emphasize the significant role of the immune system in both stroke-related damage and neuroprotection. This article investigates the relationship between
hemoglobin level and white blood cell count. Materials and methods From January 1, 2019, to April 1, 2022, all patients aged 18 years and over who were diagnosed with acute ischemic stroke in the emergency department of Kanuni Sultan Süleyman Training and Research Hospital and treated with intravenous recombinant tissue plasminogen activator (r-tPA) within 4.5 hours of stroke onset were included in this cross-sectional retrospective study. Gender, age, onset of symptoms, complaints, National Institutes of Health Stroke Scale (NIHSS) score, stroke-affected area, as well as leukocyte, neutrophil, platelet, eosinophil, lymphocyte, and
hemoglobin levels were recorded and compared between mortality and survivor groups. Results A total of 61 people, including 33 men and 28 women, were included in the study. Four patients died during follow-ups. The mean duration of symptoms upon admission was 86.23 ± 56.37 minutes. The mean NIHSS score of patients was found to be 9.16 ± 3.88 (minimum: 4, maximum: 18). There was a statistically significant positive correlation between age and symptom duration (p < 0.002, r: 0.391). A statistically significant negative correlation was found between eosinophil count and NIHSS score (p < 0.012, r: -0.321) and between eosinophil count and symptom duration (p < 0.042, r: -0.261). There was a negative correlation between
hemoglobin levels and mortality (p < 0.013, r: -0.318). A statistically significant negative correlation was observed between the eosinophil-to-neutrophil ratio (ENR) and NIHSS score (p < 0.017, r: -0.305) as well as between ENR and symptom duration (p < 0.034, r: -0.271).
Hemoglobin is a significant predictor of mortality in the logistic regression model (p < 0.05, CI: 0.253-0.942). For each one-unit increase in
hemoglobin, the odds of mortality decrease by a factor of 0.488. Conclusion Certain blood cell types (neutrophils, eosinophils, and lymphocytes) play an active role in determining stroke prognosis. A detailed explanation of the role of leukocyte types lays the foundation for \"immunomodulation,\" which could be a promising novel treatment modality for future stroke patients.