Relationship Between White Blood Cell Subtypes And Neutrophil To Lymphocyte Ratio And Prognosis Of 3 Months After Acute Cerebral Infarction

Objectives To investigate the relationship between white blood cell(WBC) subtypes, neutrophil to lymphocyte ratio(NLR) and the short-term prognosis of the patients with acute cerebral infarction.Methods A total of 622 acute cerebral infarction patients within 72 hours of onset were consecutively collected during September,2013 to December,2015 in the severe medical ward,the second and fourth nerval medical department ward of The Affiliated Hospital of North China University of Science and Technology. Collected medical records data of all patients, including demographic characteristics, the history related data of past illness, clinical features, WBC and its subtypes counts and other laboratory examinations. Calculated the neutrophil to lymphocyte ratio. When the third month after stroke onset, all the participants were followed up by trained and qualified doctors in the Department of internal medicine, and were scored according to the Modified Rankin scale(m RS). Defined study outcomes m RS>2 points for the poor prognosis, m RS≤2 points for the good prognosis. Application of SPSS17.0 software for statistical analysis. Baseline data were compared with t test or non parametric test. To use univariate and multivariate Logistic model analysis the relationship between the prognosis of different leukocyte subtypes, neutrophil to lymphocyte ratio in patients with acute cerebral infarction, and calculate Relative Risk(RR) and 95% confidence intervals(95%CI) of study outcomes among patients.Results 1 Patients with acute cerebral infarction were more likely to have a poor prognosis who have elevated WBC count, elevated neutrophil count, lymphocyte count decreased, NLR increased, high fibrin original, high systolic blood pressure, urea nitrogen elevated, low albumin, eldly age, fever, a history of smoking, history of diabetes and elevated admission NIHSS score, the difference is statistically significant(P < 0.05). The prognosis of patients with cerebral infarction in different OCSP subtypes is not all the same, the difference is statistically significant(P<0.001). 2 Multivariate Logistic regression analysis showed that, patients with acute cerebral infarction with admission total WBC count≥8.4×109/L have 2.491 times of the risk of poor prognosis than patients with total WBC count<5.6×109/L.Patients with acute cerebral infarction with neutrophil count≥6.81×109/L have 2.878 times of the risk of poor prognosis than patients with neutrophil count<3.31×109/L. Patients with acute cerebral infarction at the level of lymphocyte count(1.69~2.19)×109/L and ≥6.81×109/L have each 0.448 times and 0.307 times of the risk of poor prognosis than patients with lymphocyte count<1.24×109/L. Patients with acute cerebral infarction at the level of NLR(1.68~2.48)、(2.48~4.15) and≥4.15 have each 3.087 times、4.338 times and 9.532 times of the risk of poor prognosis than patients with NLR<1.68. 3 Linear trend test showed that the total WBC count, neutrophil count, lymphocyte count and NLR levels have dose response relationship with the outcome of the study(P< 0.05).Conclusions 1 Admission of the total WBC count, neutrophil count, lymphocyte count and NLR can be used as independent predictors of recent prognosis in patients with acute cerebral infarction. 2 The risk of recent poor prognosis in patients with acute cerebral infarction was increased with the increase of total WBC count, neutrophil count and NLR, as well as the decrease of lymphocyte count.