Correlation Analysis Of Platelet Parameters,fibrinogen Level And Degree Of Neurological Deficit In Patients With Acute Cerebral Infarction

Objective:The study aims to compare platelet parameters and fibrinogen content between patients with acute cerebral infarction and healthy controls,and to observe the correlation between these variables and the degree of neurological deficit in patients with acute cerebral infarction.The results will provide valuable information for clinicians to identify the degree of neurological deficit in patients with acute cerebral infarction in the early stages of the disease.Methods:We collected 304 patients with acute ischemic stroke who were hospitalized in the Department of Neurology,the First Affiliated Hospital of Dali University from June 2021 to December 2022 and were screened by cranial MRI+DWI.After admission,the National Institutes of Health Stroke Scale(National Institutes of Health Stroke Scale,NIHSS)score was completed.According to the evaluation results,all patients included in the Acute cerebral infarction group(Acute cerebral infarct,ACI)were divided into three subtype groups: mild stroke group(0-4 points),moderate stroke group(5-15 points),and severe stroke group(16 points and above).300 healthy people who underwent physical examination in the physical examination center of our hospital in the same year were selected as the control group,and all the subjects had complete file data.General data,laboratory data and imaging data of patients were collected.The collected data were processed by Excel,and SPSS27.0 was used for statistical analysis.The differences between the groups were compared by t test,analysis of variance and nonparametric test.The significant indicators in the single factor analysis were included in the binary logistic regression model for analysis.The risk factors related to acute cerebral infarction were screened.The correlation between nerve function defect and platelet parameters and fibrinogen level was analyzed by Spearman correlation,The diagnostic efficacy of ROC curve platelet parameters and fibrinogen level in the neurological deficit of acute cerebral infarction was evaluated.Result:1.The laboratory parameters including platelet distribution width(PDW),Mean platelet volume(MPV),fibrinogen(FIB),homocysteine(Hcy),Uric Acid(UA)and glycosylated hemoglobin(Hb Alc)were found to be significantly elevated in patients with acute cerebral infarction compared to healthy controls(P<0.05)according to the results of univariate analysis.2.According to the results of univariate analysis,after adjusting for related confounding factors,the results of multivariate analysis showed that the platelet distribution width(OR:1.619,95%CI 为 1.383-1.855);Mean platelet volume(OR: 1.214,95% CI: 1.113-1.325),uric acid(OR: 1.016,95% CI: 1.005-1.027),fibrinogen(OR: 1.496,95% CI: 1.271-1.761)and homocysteine(OR: 2.466,95% CI: 1.698-3.580)may be independent risk factors for ACI.3.The patients’ serum PDW,MPV,FIB,Hcy and UA were used to independently diagnose whether the patients had ACI and draw the ROC curve.The results showed that the area under the curve of Hcy predicting the patients’ cerebral infarction was 0.951,which was the best diagnostic value;Secondly,the area under the ROC curve drawn by FIB,MPV,UA and PDW in diagnosing whether the patient has ACI is 0.869,0.828,0.726 and 0.672 respectively.4.Comparing the clinical data indexes of each subgroup of ACI,univariate analysis showed that the scores of PDW,MPV,Hb A1 c,FIB,Hcy and NIHSS were significantly different among the three groups of patients(P<0.05).5.In the comparison of imaging data of ACI subgroups,the infarction sites of patients with different degrees of stroke were different,and the differences between the location distribution were statistically significant(P<0.05);The distribution of infarct lesions in patients with different degrees of stroke was different,and the difference between the distribution of single or multiple lesions was statistically significant(P<0.001);There was statistically significant difference in the distribution of infarct area among patients with different degrees of stroke(P<0.001).6.The platelet parameters and fibrinogen were compared among the subgroups of ACI patients,and the results showed that there were significant differences in PDW,MPV,and FIB levels among the ACI subgroups(P<0.05).there was no statistically significant difference in PLT levels among the ACI subgroups(P>0.05).7.Using patient serum PDW,MPV,and FID,ROC curves were created to independently identify ACI patients who had neurological functional impairments.The findings revealed that the optimum diagnostic value for ACI patients with neurological functional abnormalities was indicated by the ROC curve area under the three combined diagnoses,which was 0.654.PDW,MPV,and FIB were then used to identify ACI patients who had neurological functional impairments,with respective ROC curve areas of 0.640,0.639,and0.619.Conclusion:1.Comparison of general clinical data between ACI group and healthy control group showed that PDW,MPV,FIB,Hcy,UA and Hb Alc were independent risk factors for ACI patients.Serum PDW,MPV,FIB,Hcy and UA had certain predictive value for the incidence of ACI,and Hcy had the highest predictive value.2.PDW,MPV and FIB are independent risk factors for neurological impairment in ACI patients.The higher the level of PDW,MPV and FIB in ACI subgroups,the more serious the degree of neurological impairment.3.Cerebral infarction area of patients was positively correlated with PDW,MPV and FIB,and the larger the infarct area was,the more significant the changes in PDW,MPV and FIB were.4.PDW,MPV and FIB all have certain predictive value for neurological impairment in ACI patients,and their combined predictive value is higher.