Study On The Correlation Between Prognosis Of 90-day Rankin Scale And PDR,CysC,PDW In Acute Ischemic Stroke

Objective: To explore the relationship between clinical data,laboratory test indicators and prognosis of 90-day Rankin scale in patients with acute ischemic stroke,and provide help for clinical diagnosis and treatment.Methods: The clinical data of 303 patients with acute ischemic stroke admitted in the Department of Neurology of Shengjing Hospital affiliated to China Medical University from December 2020 to September 2022 were retrospectively analyzed.According to the Rankin Scale(m RS)score at the 90-day follow-up after discharge,the patients were divided into two groups: good prognosis group(m RS 0～2 points)and poor prognosis group(m RS 3～6 points).The clinical data of the two groups were compared,including the National Institutes of Health Stroke Scale(NIHSS)score,serum cystatin C,high-density lipoprotein,low-density lipoprotein,cholesterol,total bilirubin,neutrophil count,white blood cell count,platelet count,red blood cell distribution width,average platelet volume,platelet distribution width,fibrinogen,D-dimer,Whether the ratio of platelet to D-dimer is statistically significant.The independent risk factors affecting the 90-day prognosis of acute ischemic stroke were analyzed by multiple logistic regression,and the ratio of platelets to D-dimer,serum cystatin C,platelet distribution width and the effect of the combination of the three factors on the 90-day prognosis of acute ischemic stroke patients were analyzed by subject working curve(ROC).Results:(1)In the poor prognosis group,age,NIHSS score,stroke history,hypertension history,diabetes history,drinking history,cystatin C,neutrophil count,white blood cell count,platelet count,fibrinogen,D-dimer,red blood cell distribution width,average platelet volume,platelet distribution width were significantly higher than those in the good prognosis group(P<0.05);The ratio of platelets to D-dimer was significantly lower than that of patients with good prognosis(P <0.05);(3)The ROC curve analysis results of the ratio of platelets to D-dimer,cystatin C,platelet distribution width and their combined detection to judge acute ischemic stroke showed that the AUC of the ratio of platelets to D-dimer,cystatin C,and platelet distribution width were 0.712,0.704,and0.678,respectively,while the AUC of the combined detection was 0.785,which was higher than that of the single index(Z=3.009,2.438,3.748,P<0.05).The difference was statistically significant.Conclusions: NIHSS score,stroke history,platelet count,cystatin C,platelet distribution width,and the ratio of platelets to D-dimer are independent risk factors for evaluating the90-day poor prognosis of AIS patients.The detection of cystatin C and platelet distribution width combined with the ratio of platelets to D-dimer has higher evaluation value.