Prognostic value of preoperative peripheral blood inflammatory makers for carotid artery stenting ipsilateral new silence ischemic brain lesions

doi:10.3877/cma.j.issn.1673-9248.2025.01.003

Abstract

Abstract:

Objective

To investigate the value of peripheral blood inflammatory makers in predicting ipsilateral new silent ischemic brain lesions （INSIBL） following carotid artery stenting （CAS）.

Methods

A retrospective study was conducted to analyze the clinical data of 89 patients with CAS in Beijing Friendship Hospital, Capital Medice Universioy from October 2018 to February 2021. The patients were divided into two groups： the INSIBL group （40 cases） and the non-INSIBL group （49 cases）. Data collected included general information, laboratory examination results, and imaging findings. Neutrophil to lymphocyte ratio （NLR） and derived neutrophil-to-lymphocyte ratio （dNLR） in peripheral blood were used as indicators of systemic inflammation. The influencing factors of INSIBL in patients with CAS were analyzed.using independent t-tests, χ² test, Rank sum test, multivariate Logistic regression, and receiver operating characteristic （ROC） curve.

Results

（1） Systolic blood pressure on admission in the INSIBL group were statistically significantly higher than that in the non-INSIBL group ［（145.1±19.7） mmHg vs （139.2±18.7） mmHg, t=4.434, P=0.046］. （2） Lymphocyte count in the INSIBL group is lower than that in the non-INSIBL group ［1.26（0.92, 1.37）×10⁹/L vs 1.63（1.41, 1.99）×10⁹/L, Z=7.921, P=0.010］, and both NLR and dNLR were significantly higher in the INSIBL group compared to the non-INSIBL group ［NLR： 4.80 （1.98, 7.77）vs 2.38 （1.57, 3.70）, Z=13.357, P＜0.001； dNLR： 3.50 （1.65, 5.35） vs 1.62 （1.00, 2.50）, Z=12.885, P＜0.001］.（3） Multivariate Logistic regression analysis results showed that NLR ［adjusted odds ratio （aOR）=1.774, 95%confidence interval （CI）： 1.487-2.132, P=0.001］ and dNLR ［aOR=1.828, 95%CI： 1.487-2.485, P＜0.001］were independent influencing factors of CAS-INSIBL. （4） ROC curves demonstrated that the optimal cutoff value of NLR was 4.52 （sensitivity 75.0%, specificity 65.3%）, the area under the curve （AUC） value is 0.72 （95%CI：0.62-0.83, P＜0.001）. For dNLR, the optimal cutoff value was 2.87 （sensitivity 70.0%, specificity 63.3%）, the AUC value 0.70 （95%CI： 0.59-0.81, P=0.001）.

Conclusion

NLR and dNLR are independent influencing factors of CAS-INSIBL, NLR has relatively high predictive value on CAS-INSIBL.

Key words: Carotid artery stenting, Ipsilateral new silence ischemic brain lesions, Neutrophil, Lymphocyte, Systemic inflammatory

Yi Yang, Shen Shen, Mengxia Wan, Yongbo Zhang. Prognostic value of preoperative peripheral blood inflammatory makers for carotid artery stenting ipsilateral new silence ischemic brain lesions[J]. Chinese Journal of Cerebrovascular Diseases(Electronic Edition), 2025, 19(01): 13-18.

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URL: https://zhnxgbzz.cma-cmc.com.cn/EN/10.3877/cma.j.issn.1673-9248.2025.01.003

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Figures/Tables 3

项目	non-INSIBL 组（n=49）	INSIBL 组（n=40）	统计值	P 值
年龄（岁， $\overset{ˉ}{x}$ ±s）	66.5±10.0	68.2±14.9	t=3.758	0.056
男性［例（%）］	42（85.7）	35（87.5）	χ ²=0.060	0.806
高血压病史［例（%）］	39（79.6）	30（75.0）	χ ²=0.267	0.606
糖尿病病史［例（%）］	21（42.9）	18（45.0）	χ ²=0.041	0.839
高脂血症病史［例（%）］	6（12.2）	6（15.0）	χ ²=0.143	0.705
脑卒中病史［例（%）］	6（12.2）	4（10.0）	χ ²=0.111	0.739
吸烟史［例（%）］	16（32.7）	18（45.0）	χ ²=1.422	0.233
饮酒史［例（%）］	30（61.2）	25（62.5）	χ ²=0.015	0.902
冠状动脉粥样硬化性心脏病病史［例（%）］	8（16.3）	6（15.0）	χ ²=0.029	0.864
入院时收缩压（mmHg， $\overset{ˉ}{x}$ ±s）	139.2±18.7	145.1±19.7	t=4.434	0.046
入院时舒张压（mmHg， $\overset{ˉ}{x}$ ±s）	83.1±12.9	86.8±13.2	t=3.881	0.055
入院时NIHSS 评分［分，M（Q_R）］	4（2，7）	4（2，8）	Z=0.128	0.722
静脉rt-PA 治疗［例（%）］	4（8.2）	3（7.5）	χ ²=0.013	0.908
颈内动脉颅内段［例（%）］	30（61.2）	24（60.0）	χ ²=0.014	0.906
右侧颈内动脉［例（%）］	23（46.9）	21（52.5）	χ ²=0.813	0.367
开环支架［例（%）］	31（63.3）	27（67.5）	χ ²=0.174	0.677
白细胞计数［×10⁹/L，M（Q_R）］	6.32（5.03，7.19）	7.50（5.03，9.47）	Z=3.910	0.054
中性粒细胞计数［×10⁹/L，M（Q_R）］	4.36（3.43，6.02）	6.87（3.10，9.19）	Z=3.789	0.056
淋巴细胞计数［×10⁹/L，M（Q_R）］	1.63（1.41，1.99）	1.26（0.92，1.37）	Z=7.921	0.010
NLR［M（Q_R）］	2.38（1.57，3.70）	4.80（1.98，7.77）	Z=13.357	＜0.001
dNLR［M（Q_R）］	1.62（1.00，2.50）	3.50（1.65，5.35）	Z=12.885	＜0.001

项目	non-INSIBL 组（n=49）	INSIBL 组（n=40）	统计值	P 值
年龄（岁， $\overset{ˉ}{x}$ ±s）	66.5±10.0	68.2±14.9	t=3.758	0.056
男性［例（%）］	42（85.7）	35（87.5）	χ ²=0.060	0.806
高血压病史［例（%）］	39（79.6）	30（75.0）	χ ²=0.267	0.606
糖尿病病史［例（%）］	21（42.9）	18（45.0）	χ ²=0.041	0.839
高脂血症病史［例（%）］	6（12.2）	6（15.0）	χ ²=0.143	0.705
脑卒中病史［例（%）］	6（12.2）	4（10.0）	χ ²=0.111	0.739
吸烟史［例（%）］	16（32.7）	18（45.0）	χ ²=1.422	0.233
饮酒史［例（%）］	30（61.2）	25（62.5）	χ ²=0.015	0.902
冠状动脉粥样硬化性心脏病病史［例（%）］	8（16.3）	6（15.0）	χ ²=0.029	0.864
入院时收缩压（mmHg， $\overset{ˉ}{x}$ ±s）	139.2±18.7	145.1±19.7	t=4.434	0.046
入院时舒张压（mmHg， $\overset{ˉ}{x}$ ±s）	83.1±12.9	86.8±13.2	t=3.881	0.055
入院时NIHSS 评分［分，M（Q_R）］	4（2，7）	4（2，8）	Z=0.128	0.722
静脉rt-PA 治疗［例（%）］	4（8.2）	3（7.5）	χ ²=0.013	0.908
颈内动脉颅内段［例（%）］	30（61.2）	24（60.0）	χ ²=0.014	0.906
右侧颈内动脉［例（%）］	23（46.9）	21（52.5）	χ ²=0.813	0.367
开环支架［例（%）］	31（63.3）	27（67.5）	χ ²=0.174	0.677
白细胞计数［×10⁹/L，M（Q_R）］	6.32（5.03，7.19）	7.50（5.03，9.47）	Z=3.910	0.054
中性粒细胞计数［×10⁹/L，M（Q_R）］	4.36（3.43，6.02）	6.87（3.10，9.19）	Z=3.789	0.056
淋巴细胞计数［×10⁹/L，M（Q_R）］	1.63（1.41，1.99）	1.26（0.92，1.37）	Z=7.921	0.010
NLR［M（Q_R）］	2.38（1.57，3.70）	4.80（1.98，7.77）	Z=13.357	＜0.001
dNLR［M（Q_R）］	1.62（1.00，2.50）	3.50（1.65，5.35）	Z=12.885	＜0.001

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