The Relationship Between Peripheral Blood NLR、PLR、MLR And Carotid Plaque Stability In Patients With Acute Ischemic Stroke

Objective:The objective of this study was to analyze the changes of peripheral blood neutrophil-to-lymphocyte ratio(NLR),platelet-to-neutrophil ratio(PLR)and monocyteto-lymphocyte ratio(MLR)in patients with acute ischemic stroke,to evaluate the relationship between NLR,PLR,MLR and carotid plaque stability.Methods:A total of 179 patients with acute ischemic stroke(AIS)for the first time from March 2018 to December 2021 who were admitted to the Department of Neurology,Shanxi Provincial People’s Hospital were included.In addition,91 health examinees were selected as the control group.General clinical data were collected and peripheral blood NLR,PLR and MLR levels were measured.Carotid artery ultrasound was used to assess the presence and stability of carotid plaque,according to the echo characteristics of plaques,the plaques were divided into non-plaque,stable plaque and vulnerable plaque groups.Collate data and make statistical analysis.Results:1.A total of 179 AIS patients were included in this study,including 134 males and45 females with an average age of(56.93 ± 9.94)years.Of the 179 patients,60(33.5%)had no carotid plaque,119(66.5%)had carotid plaque,of which 50.4%(60/119)had stable plaque and 49.6%(59/119)had vulnerable plaque.According to the stability of carotid plaque,patients were divided into non-plaque group(60 cases),stable plaque group(60 cases)and vulnerable plaque group(59 cases).The prevalence of carotid plaque was 66.5% in AIS patients.2.Age,Male,history of hypertension,history of smoking,systolic blood pressure(SBP),total cholesterol(TC),low-density lipoprotein cholesterol(LDL-C),high-density high-density lipoprotein cholesterol(HDL-C),white blood cell(WBC),neutrophil(N),monocyte(m),NLR,MLR were significantly different among the four groups(P <0.05),PLR had no statistical significance(P > 0.05),the levels of NLR and MLR in vulnerable plaque group were significantly higher than those in stable plaque group,non-plaque group and health group.3.The results of Spearman correlation analysis showed that the vulnerability of carotid plaque was positively correlated with NLR(r=0.497,P <0.001)and MLR(r=0.553,P <0.001).4.In combination with clinical practice,the meaningful variables in the univariate analysis were included in the multi-category logistic analysis,NLR(OR:1.294;95%CI:1.013-1.650;P =0.039)and MLR(OR:3.922;95%CI:2.439-6.289;P <0.001)were the independent risk factors for carotid vulnerable plaque,PLR(P = 0.988)was not an independent risk factor for vulnerable plaque.Conclusion:1.Carotid plaque is common in AIS patients.2.Age,Male,history of hypertension,smoking history,SBP,TC,LDL-C,HDL-C,WBC,N,M,NLR,MLR were different in healthy people and AIS patients with different stable degrees of carotid plaque,NLR and MLR of vulnerable plaque group were higher than those of other three groups.3.Carotid plaque vulnerability was positively correlated with NLR and MLR.4.The independent risk factors of carotid vulnerable plaque in AIS patients were NLR,MLR.The relationship between PLR and the stability of carotid vulnerable plaque needs further study.