| ObjectiveTo observe the changes of neutrophil to lymphocyte ratio(NLR)in patients of spontaneous hemorrhagic transformation(HT),and to investigate the role of NLR in the pathogenesis of spontaneous HT.MethodsWe studied 614 patients with ischemic stroke within 3 days of initial symptom onset,and 108(17.6%)were diagnosed spontaneous HT.The general clinical data were compared between the HT group and non-HT group.Logistic regression analyses were done to investigate the association between NLR and spontaneous HT.All patients were divided into different subgroups by the levels of NLR to represent an integrated population study of spontaneous HT.Statistical analysis could be performed after eliminating all patients with atrial fibrillation to further explore the role of antithrombus treatment in spontaneous HT.ResultsLogistic regression analysis showed that NLR was independently associated with HT(OR1.16;95%CI 1.08 to 1.23).The best cut-off value of NLR was 3.14(sensitivity 79.6%,specificity 59.7%)for HT.The risk of spontaneous HT in the 4th quartile and 3th quartile subgroups of NLR was significantly increased compared with that in the 1st quartile of NLR(p<0.05).According to the cut-off value of NLR,the patients were divided into two groups,those of patients with high NLR(?3.14)had a 4.0-fold increased risk for HT(95%CI 2.17 to 7.68)compared to patients with low NLR(<3.14).In subgroup analyses,according to the level of NLR,anticoagulation therapy raises the risk of HT up to 3.6-times(95%Cl 1.14 to 11.51)compared with antiplatelet therapy.ConclusionThe level of NLR was an independent risk factor of spontaneous HT.The relative risk of spontaneous HT was 4.0-fold increased risk in the patients with NLR level of greater than 3.14 compared to patients with lower NLR.Furthermore,for patients with non-atrial fibrillation-associated ischemic stroke,if the value of NLR was more than 3.14,anticoagulation therapy raised the risk of HT up to 3.6-times compared with antiplatelet therapy. |
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