PNR、MHR、NHR与急性缺血性脑卒中相关性研究进展

张 雨婷1, 李 淑雅1, 李 泽光2, 高 娟*2
1、承德医学院
2、保定市第一中心医院

摘要


急性缺血性脑卒中（AIS）作为全球范围内导致残疾和死亡的重要原因，其发病机制复杂，涉及炎症反应、脂质代谢异常及血栓形成等多个方面。近年来，基于常规血液检测的新型复合炎症指标，如血小板与中性粒细胞比值（PNR）、单核细胞与高密度脂蛋白比值（MHR）、中性粒细胞与高密度脂蛋白比值（NHR），在AIS研究中逐渐受到关注。这些指标综合反映了机体的炎症状态、免疫功能及脂质代谢情况，有望为AIS的早期诊断、病情评估和预后预测提供新的视角和生物标志物。本文就PNR、MHR、NHR与急性缺血性脑卒中的相关性研究进展进行综述。炎症反应在AIS中关键，中性粒细胞、单核细胞参与炎症及组织损伤，高密度脂蛋白（HDL）具保护作用。PNR与AIS患者神经功能及预后相关，是预后独立保护因素，可作预后潜在指标。MHR反映慢性炎症和血脂异常，与缺血性脑卒中线性相关，对缺血性卒中有预测价值，可能通过反映动脉粥样硬化程度影响AIS。NHR与AIS密切相关，是独立危险因素，与NIHSS评分正相关，还可预测静脉溶栓后出血转化。目前研究样本量小、存在地域差异，机制及与其他危险因素交互作用不明，需大规模研究明确其价值，为AIS防治提供策略。

关键词


急性缺血性脑卒中；PNR；MHR；NHR；神经功能；预后评估

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参考


[1]Group R on S C in C W.《中国卒中中心报告2022》概要[J].中国脑血管病杂志，2024，21（8）：565-576.

[2]Helleberg B H, Ellekjaer H, Indredavik B. Outcomes after early neurological deterioration and transitory deterioration in acute ischemic stroke patients[J]. Cerebrovascular Diseases, 2016, 42(5-6): 378-386.

[3]Schrottmaier W C, Mussbacher M, Salzmann M, et al. Platelet-leukocyte interplay during vascular disease[J]. Atherosclerosis, 2020, 307: 109-120.

[4]Wang Y, Liu C, Ren Y, et al. Nanomaterial-based strategies for attenuating T-cell-mediated immunodepression in stroke patients: Advancing research perspectives[J]. International Journal of Nanomedicine, 2024, Volume 19: 5793-5812.

[5]Gong P, Liu Y, Gong Y, et al. The association of neutrophil to lymphocyte ratio, platelet to lymphocyte ratio, and lymphocyte to monocyte ratio with post-thrombolysis early neurological outcomes in patients with acute ischemic stroke[J]. Journal of Neuroinflammation, 2021, 18(1): 51.

[6]De Meyer S F, Langhauser F, Haupeltshofer S, et al. Thromboinflammation in brain ischemia: Recent updates and future perspectives[J]. Stroke, 2022, 53(5): 1487-1499.

[7]Wang L, Cheng Q, Peng M, et al. The relationship between the platelet to leukocyte ratio and mechanical thrombectomy outcomes in acute ischemic stroke patients[J]. Neurological Research, 2020, 42(10): 890-896.

[8]Franks Z G, Campbell R A, Weyrich A S, et al. Platelet-leukocyte interactions link inflammatory and thromboembolic events in ischemic stroke[J]. Annals of the New York Academy of Sciences, 2010, 1207(1): 11-17.

[9]Spronk E, Sykes G, Falcione S, et al. Hemorrhagic transformation in ischemic stroke and the role of inflammation[J]. Frontiers in Neurology, 2021, 12: 661955.

[10]Ganjali S, Gotto A M, Ruscica M, et al. Monocyte‐to‐HDL‐cholesterol ratio as a prognostic marker in cardiovascular diseases[J]. Journal of Cellular Physiology, 2018, 233(12): 9237-9246.

[11]Meng D, Li Y, Ju T, et al. Low MHR is associated with hemorrhagic transformation in acute large artery atherosclerosis ischemic stroke patients with intravenous thrombolysis[J]. Clinical and Applied Thrombosis/Hemostasis, 2023, 29: 10760296231167849.

[12]Pluta R, Januszewski S, Czuczwar S J. Neuroinflammation in post-ischemic neurodegeneration of the brain: Friend, foe, or both?[J]. International Journal of Molecular Sciences, 2021, 22(9): 4405.

[13]Geng L, Zuo L, Li H, et al. Association of platelet-to-neutrophil ratios with 1-year outcome and mortality in patients with acute ischemic stroke[J]. Neuroscience Letters, 2023, 798: 137016.

[14]Gao B, Pan W, Hu X, et al. Neutrophil-related ratios predict the 90-day outcome in acute ischemic stroke patients after intravenous thrombolysis[J]. Frontiers in Physiology, 2021, 12: 670323.

[15]Wang C, Zhang Q, Ji M, et al. Prognostic value of the neutrophil-to-lymphocyte ratio in acute ischemic stroke patients treated with intravenous thrombolysis: A systematic review and meta-analysis[J]. BMC Neurology, 2021, 21(1): 191.

[16]Sharma D, Aravind S, Joseph S, et al. The role of monocyte to high-density lipoprotein cholesterol ratio in predicting the severity of acute ischemic stroke and its association with the NIHSS[J]. Journal of the Association of Physicians of India, 2023, 71(8).

[17]Li Y, Zhang M, Xue M, et al. Elevated monocyte-to-HDL cholesterol ratio predicts post-stroke depression[J]. Frontiers in Psychiatry, 2022, 13: 902022.

[18]Bolayir A, Gokce S F, Cigdem B, et al. Monocyte/high-density lipoprotein ratio predicts the mortality in ischemic stroke patients[J]. Neurologia i Neurochirurgia Polska, 2018, 52(2): 150-155.

[19]Sun Y, Lu J, Zheng D, et al. Predictive value of monocyte to HDL cholesterol ratio for stroke-associated pneumonia in patients with acute ischemic stroke[J]. Acta Neurologica Belgica, 2021, 121(6): 1575-1581.

[20]Li X, Wu F, Jiang C, et al. Novel peripheral blood cell ratios: Effective 3-month post-mechanical thrombectomy prognostic biomarkers for acute ischemic stroke patients[J]. Journal of Clinical Neuroscience, 2021, 89: 56-64.

[21]Yu L, Ma K, Hao J, et al. Neutrophil to high-density lipoprotein cholesterol ratio, a novel risk factor associated with acute ischemic stroke[J]. Medicine, 2023, 102(26): e34173.

[22]Zhang R, Jin F, Zheng L, et al. Neutrophil to high-density lipoprotein ratio is associated with hemorrhagic transformation in patients with acute ischemic stroke[J]. Journal of Inflammation Research, 2022, Volume 15: 6073-6085.

[23]Zhang A, Zhu Y, Liao J, et al. The association of systemic inflammatory response index and neutrophil-to-high-density lipoprotein ratio mediated by fasting blood glucose with 90-day prognosis in acute ischemic stroke patients[J]. Neuroepidemiology, 2024: 1-12.

[24]Ci S, Li D, Wang F, et al. Correlation between neutrophil-to-high-density lipoprotein cholesterol ratio (NHR) and adverse prognosis in patients who achieve complete recanalization after thrombectomy for acute large vessel occlusion stroke[J]. Frontiers in Neurology, 2025, 16: 1536535.


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