Research progress on the correlation between parameters related to blood routine examination and acute cerebral infarction_West China Medical Journal

Authors：

LI Jie , ZHOU Fangming ,  LIU Shiping

Department of General Medicine, Affiliated Hospital of North Sichuan Medical College, Nanchong, Sichuan 637000, P. R. China;

Corresponding author：

LIU Shiping, Email: liusp456@163.com

Keywords：

Acute cerebral infarction; red cell volume distribution width; mean platelet volume; neutrophil to lymphocyte ratio; platelet to lymphocyte ratio; inflammation

DOI：

10.7507/1002-0179.202201035

Video：

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Acute cerebral infarction is characterized by high incidence rate, high recurrence rate, high disability rate and multiple complications. Early evaluation and treatment of acute cerebral infarction is particularly important to improve the survival rate and prognosis of patients. As an easily available clinical laboratory indicator, blood routine test can reflect the pathological changes in the body to a certain extent. In recent years, many studies have shown that the indicators such as red cell volume distribution width, mean platelet volume, neutrophil to lymphocyte ratio and platelet to lymphocyte ratio in blood routine examination have important values in the onset, severity and prognosis of acute cerebral infarction. This article reviews the correlations of the above parameters and ratio parameters with acute cerebral infarction, in order to provide some reference and basis for clinical diagnosis, treatment and prognosis evaluation of acute cerebral infarction.

Citation： LI Jie, ZHOU Fangming, LIU Shiping. Research progress on the correlation between parameters related to blood routine examination and acute cerebral infarction. West China Medical Journal, 2022, 37(11): 1715-1719. doi: 10.7507/1002-0179.202201035 Copy

1.	GBD 2019 Stroke Collaborators. Global, regional, and national burden of stroke and its risk factors, 1990-2019: a systematic analysis for the Global Burden of Disease Study 2019. Lancet Neurol, 2021, 20(10): 795-820.
2.	中华医学会神经病学分会, 中华医学会神经病学分会脑血管病学组. 中国急性缺血性脑卒中诊治指南 2018. 中华神经科杂志, 2018, 51(9): 666-682.
3.	Maida CD, Norrito RL, Daidone M, et al. Neuroinflammatory mechanisms in ischemic stroke: focus on cardioembolic stroke, background, and therapeutic approaches. Int J Mol Sci, 2020, 21(18): 6454.
4.	Wang Z, Korantzopoulos P, Roever L, et al. Red blood cell distribution width and atrial fibrillation. Biomark Med, 2020, 14(13): 1289-1298.
5.	Talarico M, Manicardi M, Vitolo M, et al. Red cell distribution width and patient outcome in cardiovascular disease: a “real-world” analysis. J Cardiovasc Dev Dis, 2021, 8(10): 120.
6.	Xanthopoulos A, Giamouzis G, Dimos A, et al. Red blood cell distribution width in heart failure: pathophysiology, prognostic role, controversies and dilemmas. J Clin Med, 2022, 11(7): 1951.
7.	Söderholm M, Borné Y, Hedblad B, et al. Red cell distribution width in relation to incidence of stroke and carotid atherosclerosis: a population-based cohort study. PLoS One, 2015, 10(5): e0124957.
8.	Lappegård J, Ellingsen TS, Skjelbakken T, et al. Red cell distribution width is associated with future risk of incident stroke. The Tromsø Study. Thromb Haemost, 2016, 115(1): 126-134.
9.	Mohindra R, Mishra U, Mathew R, et al. Red cell distribution width (RDW) index as a predictor of severity of acute ischemic stroke: a correlation study. Adv J Emerg Med, 2019, 4(2): e24.
10.	Lorente L, Martín MM, Abreu-González P, et al. Early mortality of brain infarction patients and red blood cell distribution width. Brain Sci, 2020, 10(4): 196.
11.	Pinho J, Marques SA, Freitas E, et al. Red cell distribution width as a predictor of 1-year survival in ischemic stroke patients treated with intravenous thrombolysis. Thromb Res, 2018, 164: 4-8.
12.	Fan H, Liu X, Li S, et al. High red blood cell distribution width levels could increase the risk of hemorrhagic transformation after intravenous thrombolysis in acute ischemic stroke patients. Aging (Albany NY), 2021, 13(16): 20762-20773.
13.	Kim DY, Hong DY, Kim SY, et al. Prognostic value of red blood cell distribution width in predicting 3-month functional outcome of patients undergoing thrombolysis treatment for acute ischemic stroke. Medicine (Baltimore), 2021, 100(37): e27255.
14.	Choi DH, Kang SH, Song H. Mean platelet volume: a potential biomarker of the risk and prognosis of heart disease. Korean J Intern Med, 2016, 31(6): 1009-1017.
15.	Zheng M, Chen S, Zhu Y, et al. Mean platelet volume: a new predictor of ischaemic stroke risk in patients with nonvalvular atrial fibrillation. BMC Cardiovasc Disord, 2020, 20(1): 241.
16.	Du J, Wang Q, He B, et al. Association of mean platelet volume and platelet count with the development and prognosis of ischemic and hemorrhagic stroke. Int J Lab Hematol, 2016, 38(3): 233-239.
17.	Korniluk A, Koper-Lenkiewicz OM, Kamińska J, et al. Mean platelet volume (MPV): new perspectives for an old marker in the course and prognosis of inflammatory conditions. Mediators Inflamm, 2019, 2019: 9213074.
18.	Staszewski J, Pogoda A, Data K, et al. The mean platelet volume on admission predicts unfavorable stroke outcomes in patients treated with IV thrombolysis. Clin Interv Aging, 2019, 14: 493-503.
19.	Mohamed AB, Elnady HM, Alhewaig HK, et al. The mean platelet volume and plateletcrit as predictors of short-term outcome of acute ischemic stroke. Egypt J Neurol Psychiatr Neurosurg, 2019, 55(1): 4.
20.	Ghodsi H, Abouei Mehrizi MA, Khoshdel AR, et al. Evaluation of combining Alberta Stroke Program Early CT Score (ASPECTS) with mean platelet volume, plateletcrit, and platelet count in predicting short- and long-term prognosis of patients with acute ischemic stroke. Clin Neurol Neurosurg, 2021, 208: 106830.
21.	余招平, 武爱梅, 黄芳, 等. 平均血小板体积评价急性缺血性脑卒中静脉溶栓患者短期预后的价值研究. 中国临床神经科学, 2021, 29(4): 415-420, 428.
22.	Chen Z, He Y, Su Y, et al. Association of inflammatory and platelet volume markers with clinical outcome in patients with anterior circulation ischaemic stroke after endovascular thrombectomy. Neurol Res, 2021, 43(6): 503-510.
23.	Ntaios G, Gurer O, Faouzi M, et al. Mean platelet volume in the early phase of acute ischemic stroke is not associated with severity or functional outcome. Cerebrovasc Dis, 2010, 29(5): 484-489.
24.	Li W, Hou M, Ding Z, et al. Prognostic value of neutrophil-to-lymphocyte ratio in stroke: a systematic review and meta-analysis. Front Neurol, 2021, 12: 686983.
25.	Sharma D, Spring KJ, Bhaskar SMM. Neutrophil-lymphocyte ratio in acute ischemic stroke: immunopathology, management, and prognosis. Acta Neurol Scand, 2021, 144(5): 486-499.
26.	Suh B, Shin DW, Kwon HM, et al. Elevated neutrophil to lymphocyte ratio and ischemic stroke risk in generally healthy adults. PLoS One, 2017, 12(8): e0183706.
27.	Corriere T, Di Marca S, Cataudella E, et al. Neutrophil-to-lymphocyte ratio is a strong predictor of atherosclerotic carotid plaques in older adults. Nutr Metab Cardiovasc Dis, 2018, 28(1): 23-27.
28.	Huang LY, Sun FR, Yin JJ, et al. Associations of the neutrophil to lymphocyte ratio with intracranial artery stenosis and ischemic stroke. BMC Neurol, 2021, 21(1): 56.
29.	Hu ZB, Zhong QQ, Lu ZX, et al. Association of neutrophil-to-lymphocyte ratio with the risk of fatal stroke occurrence in older Chinese. Clin Appl Thromb Hemost, 2022, 28: 10760296221098720.
30.	胡永毅, 冯力, 韩莹, 等. 外周血 NLR、PLR、MLR 联合血清 sST2 对急性冠脉综合征患者的预后评价价值. 华南国防医学杂志, 2021, 35(11): 801-805.
31.	Cupp MA, Cariolou M, Tzoulaki I, et al. Neutrophil to lymphocyte ratio and cancer prognosis: an umbrella review of systematic reviews and meta-analyses of observational studies. BMC Med, 2020, 18(1): 360.
32.	Huang Z, Fu Z, Huang W, et al. Prognostic value of neutrophil-to-lymphocyte ratio in sepsis: a meta-analysis. Am J Emerg Med, 2020, 38(3): 641-647.
33.	Piri Cinar B, Kunt R, Yuksel B, et al. Assessment of the relation between the neutrophil to lymphocyte ratio and severity of ischemic stroke in a large cohort. Int J Clin Pract, 2021, 75(4): e13955.
34.	Xue J, Huang W, Chen X, et al. Neutrophil-to-lymphocyte ratio is a prognostic marker in acute ischemic stroke. J Stroke Cerebrovasc Dis, 2017, 26(3): 650-657.
35.	Kocaturk O, Besli F, Gungoren F, et al. The relationship among neutrophil to lymphocyte ratio, stroke territory, and 3-month mortality in patients with acute ischemic stroke. Neurol Sci, 2019, 40(1): 139-146.
36.	Liu YL, Lu JK, Yin HP, et al. High neutrophil-to-lymphocyte ratio predicts hemorrhagic transformation in acute ischemic stroke patients treated with intravenous thrombolysis. Int J Hypertens, 2020, 2020: 5980261.
37.	Burkard P, Vögtle T, Nieswandt B. Platelets in thrombo-inflammation: concepts, mechanisms, and therapeutic strategies for ischemic stroke. Hamostaseologie, 2020, 40(2): 153-164.
38.	张珂, 郝正阳, 吴磊明, 等. NLR、PLR 与非瓣膜性心房颤动患者缺血性脑卒中风险的相关性. 河南医学研究, 2022, 31(6): 996-999.
39.	Varım C, Varım P, Acar BA, et al. Usefulness of the platelet-to-lymphocyte ratio in predicting the severity of carotid artery stenosis in patients undergoing carotid angiography. Kaohsiung J Med Sci, 2016, 32(2): 86-90.
40.	İdil Soylu A, Arıkan Cortcu S, Uzunkaya F, et al. The correlation of the platelet-to-lymphocyte ratio with the severity of stenosis and stroke in patients with carotid arterial disease. Vascular, 2017, 25(3): 299-306.
41.	Altintas O, Altintas MO, Tasal A, et al. The relationship of platelet-to-lymphocyte ratio with clinical outcome and final infarct core in acute ischemic stroke patients who have undergone endovascular therapy. Neurol Res, 2016, 38(9): 759-765.
42.	Xu JH, He XW, Li Q, et al. Higher platelet-to-lymphocyte ratio is associated with worse outcomes after intravenous thrombolysis in acute ischaemic stroke. Front Neurol, 2019, 10: 1192.
43.	Chen C, Gu L, Chen L, et al. Neutrophil-to-lymphocyte ratio and platelet-to-lymphocyte ratio as potential predictors of prognosis in acute ischemic stroke. Front Neurol, 2021, 11: 525621.
44.	Yang Y, Xie D, Zhang Y. Increased platelet-to-lymphocyte ratio is an independent predictor of hemorrhagic transformation and in-hospital mortality among acute ischemic stroke with large-artery atherosclerosis patients. Int J Gen Med, 2021, 14: 7545-7555.

1. GBD 2019 Stroke Collaborators. Global, regional, and national burden of stroke and its risk factors, 1990-2019: a systematic analysis for the Global Burden of Disease Study 2019. Lancet Neurol, 2021, 20(10): 795-820.
2. 中华医学会神经病学分会, 中华医学会神经病学分会脑血管病学组. 中国急性缺血性脑卒中诊治指南 2018. 中华神经科杂志, 2018, 51(9): 666-682.
3. Maida CD, Norrito RL, Daidone M, et al. Neuroinflammatory mechanisms in ischemic stroke: focus on cardioembolic stroke, background, and therapeutic approaches. Int J Mol Sci, 2020, 21(18): 6454.
4. Wang Z, Korantzopoulos P, Roever L, et al. Red blood cell distribution width and atrial fibrillation. Biomark Med, 2020, 14(13): 1289-1298.
5. Talarico M, Manicardi M, Vitolo M, et al. Red cell distribution width and patient outcome in cardiovascular disease: a “real-world” analysis. J Cardiovasc Dev Dis, 2021, 8(10): 120.
6. Xanthopoulos A, Giamouzis G, Dimos A, et al. Red blood cell distribution width in heart failure: pathophysiology, prognostic role, controversies and dilemmas. J Clin Med, 2022, 11(7): 1951.
7. Söderholm M, Borné Y, Hedblad B, et al. Red cell distribution width in relation to incidence of stroke and carotid atherosclerosis: a population-based cohort study. PLoS One, 2015, 10(5): e0124957.
8. Lappegård J, Ellingsen TS, Skjelbakken T, et al. Red cell distribution width is associated with future risk of incident stroke. The Tromsø Study. Thromb Haemost, 2016, 115(1): 126-134.
9. Mohindra R, Mishra U, Mathew R, et al. Red cell distribution width (RDW) index as a predictor of severity of acute ischemic stroke: a correlation study. Adv J Emerg Med, 2019, 4(2): e24.
10. Lorente L, Martín MM, Abreu-González P, et al. Early mortality of brain infarction patients and red blood cell distribution width. Brain Sci, 2020, 10(4): 196.
11. Pinho J, Marques SA, Freitas E, et al. Red cell distribution width as a predictor of 1-year survival in ischemic stroke patients treated with intravenous thrombolysis. Thromb Res, 2018, 164: 4-8.
12. Fan H, Liu X, Li S, et al. High red blood cell distribution width levels could increase the risk of hemorrhagic transformation after intravenous thrombolysis in acute ischemic stroke patients. Aging (Albany NY), 2021, 13(16): 20762-20773.
13. Kim DY, Hong DY, Kim SY, et al. Prognostic value of red blood cell distribution width in predicting 3-month functional outcome of patients undergoing thrombolysis treatment for acute ischemic stroke. Medicine (Baltimore), 2021, 100(37): e27255.
14. Choi DH, Kang SH, Song H. Mean platelet volume: a potential biomarker of the risk and prognosis of heart disease. Korean J Intern Med, 2016, 31(6): 1009-1017.
15. Zheng M, Chen S, Zhu Y, et al. Mean platelet volume: a new predictor of ischaemic stroke risk in patients with nonvalvular atrial fibrillation. BMC Cardiovasc Disord, 2020, 20(1): 241.
16. Du J, Wang Q, He B, et al. Association of mean platelet volume and platelet count with the development and prognosis of ischemic and hemorrhagic stroke. Int J Lab Hematol, 2016, 38(3): 233-239.
17. Korniluk A, Koper-Lenkiewicz OM, Kamińska J, et al. Mean platelet volume (MPV): new perspectives for an old marker in the course and prognosis of inflammatory conditions. Mediators Inflamm, 2019, 2019: 9213074.
18. Staszewski J, Pogoda A, Data K, et al. The mean platelet volume on admission predicts unfavorable stroke outcomes in patients treated with IV thrombolysis. Clin Interv Aging, 2019, 14: 493-503.
19. Mohamed AB, Elnady HM, Alhewaig HK, et al. The mean platelet volume and plateletcrit as predictors of short-term outcome of acute ischemic stroke. Egypt J Neurol Psychiatr Neurosurg, 2019, 55(1): 4.
20. Ghodsi H, Abouei Mehrizi MA, Khoshdel AR, et al. Evaluation of combining Alberta Stroke Program Early CT Score (ASPECTS) with mean platelet volume, plateletcrit, and platelet count in predicting short- and long-term prognosis of patients with acute ischemic stroke. Clin Neurol Neurosurg, 2021, 208: 106830.
21. 余招平, 武爱梅, 黄芳, 等. 平均血小板体积评价急性缺血性脑卒中静脉溶栓患者短期预后的价值研究. 中国临床神经科学, 2021, 29(4): 415-420, 428.
22. Chen Z, He Y, Su Y, et al. Association of inflammatory and platelet volume markers with clinical outcome in patients with anterior circulation ischaemic stroke after endovascular thrombectomy. Neurol Res, 2021, 43(6): 503-510.
23. Ntaios G, Gurer O, Faouzi M, et al. Mean platelet volume in the early phase of acute ischemic stroke is not associated with severity or functional outcome. Cerebrovasc Dis, 2010, 29(5): 484-489.
24. Li W, Hou M, Ding Z, et al. Prognostic value of neutrophil-to-lymphocyte ratio in stroke: a systematic review and meta-analysis. Front Neurol, 2021, 12: 686983.
25. Sharma D, Spring KJ, Bhaskar SMM. Neutrophil-lymphocyte ratio in acute ischemic stroke: immunopathology, management, and prognosis. Acta Neurol Scand, 2021, 144(5): 486-499.
26. Suh B, Shin DW, Kwon HM, et al. Elevated neutrophil to lymphocyte ratio and ischemic stroke risk in generally healthy adults. PLoS One, 2017, 12(8): e0183706.
27. Corriere T, Di Marca S, Cataudella E, et al. Neutrophil-to-lymphocyte ratio is a strong predictor of atherosclerotic carotid plaques in older adults. Nutr Metab Cardiovasc Dis, 2018, 28(1): 23-27.
28. Huang LY, Sun FR, Yin JJ, et al. Associations of the neutrophil to lymphocyte ratio with intracranial artery stenosis and ischemic stroke. BMC Neurol, 2021, 21(1): 56.
29. Hu ZB, Zhong QQ, Lu ZX, et al. Association of neutrophil-to-lymphocyte ratio with the risk of fatal stroke occurrence in older Chinese. Clin Appl Thromb Hemost, 2022, 28: 10760296221098720.
30. 胡永毅, 冯力, 韩莹, 等. 外周血 NLR、PLR、MLR 联合血清 sST2 对急性冠脉综合征患者的预后评价价值. 华南国防医学杂志, 2021, 35(11): 801-805.
31. Cupp MA, Cariolou M, Tzoulaki I, et al. Neutrophil to lymphocyte ratio and cancer prognosis: an umbrella review of systematic reviews and meta-analyses of observational studies. BMC Med, 2020, 18(1): 360.
32. Huang Z, Fu Z, Huang W, et al. Prognostic value of neutrophil-to-lymphocyte ratio in sepsis: a meta-analysis. Am J Emerg Med, 2020, 38(3): 641-647.
33. Piri Cinar B, Kunt R, Yuksel B, et al. Assessment of the relation between the neutrophil to lymphocyte ratio and severity of ischemic stroke in a large cohort. Int J Clin Pract, 2021, 75(4): e13955.
34. Xue J, Huang W, Chen X, et al. Neutrophil-to-lymphocyte ratio is a prognostic marker in acute ischemic stroke. J Stroke Cerebrovasc Dis, 2017, 26(3): 650-657.
35. Kocaturk O, Besli F, Gungoren F, et al. The relationship among neutrophil to lymphocyte ratio, stroke territory, and 3-month mortality in patients with acute ischemic stroke. Neurol Sci, 2019, 40(1): 139-146.
36. Liu YL, Lu JK, Yin HP, et al. High neutrophil-to-lymphocyte ratio predicts hemorrhagic transformation in acute ischemic stroke patients treated with intravenous thrombolysis. Int J Hypertens, 2020, 2020: 5980261.
37. Burkard P, Vögtle T, Nieswandt B. Platelets in thrombo-inflammation: concepts, mechanisms, and therapeutic strategies for ischemic stroke. Hamostaseologie, 2020, 40(2): 153-164.
38. 张珂, 郝正阳, 吴磊明, 等. NLR、PLR 与非瓣膜性心房颤动患者缺血性脑卒中风险的相关性. 河南医学研究, 2022, 31(6): 996-999.
39. Varım C, Varım P, Acar BA, et al. Usefulness of the platelet-to-lymphocyte ratio in predicting the severity of carotid artery stenosis in patients undergoing carotid angiography. Kaohsiung J Med Sci, 2016, 32(2): 86-90.
40. İdil Soylu A, Arıkan Cortcu S, Uzunkaya F, et al. The correlation of the platelet-to-lymphocyte ratio with the severity of stenosis and stroke in patients with carotid arterial disease. Vascular, 2017, 25(3): 299-306.
41. Altintas O, Altintas MO, Tasal A, et al. The relationship of platelet-to-lymphocyte ratio with clinical outcome and final infarct core in acute ischemic stroke patients who have undergone endovascular therapy. Neurol Res, 2016, 38(9): 759-765.
42. Xu JH, He XW, Li Q, et al. Higher platelet-to-lymphocyte ratio is associated with worse outcomes after intravenous thrombolysis in acute ischaemic stroke. Front Neurol, 2019, 10: 1192.
43. Chen C, Gu L, Chen L, et al. Neutrophil-to-lymphocyte ratio and platelet-to-lymphocyte ratio as potential predictors of prognosis in acute ischemic stroke. Front Neurol, 2021, 11: 525621.
44. Yang Y, Xie D, Zhang Y. Increased platelet-to-lymphocyte ratio is an independent predictor of hemorrhagic transformation and in-hospital mortality among acute ischemic stroke with large-artery atherosclerosis patients. Int J Gen Med, 2021, 14: 7545-7555.

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