Assessment Of Risk Factors Related To Neutrophil Count And Recurrence Of Non-disabling Ischemic Cerebrovascular Events

Background and objective: China has a large number of patients with non-disabled ischemic cerebrovascular disease,and the incidence is on the rise.the risk of recurrence is high and there is a certain disability rate.Early intervention in patients with high risk of recurrence can significantly reduce the risk of recurrence of acute cerebrovascular disease.A series of risk factors for early stroke recurrence in patients with non-disabling ischemic cerebrovascular disease have been evaluated,including clinical prediction model,imaging prediction and biomarker prediction.The purpose of this study was to explore the risk assessment of neutrophil count in admission routine examination items,and to explore the predictive value of ABCD scoring system for stroke recurrence risk in NICE patients.Patients with high risk of recurrence were treated with early intervention and individualized treatment to reduce the risk of stroke recurrence.Methods: 251 patients with non-disabled ischemic cerebrovascular disease were treated in the Department of Neurology,Subei people's Hospital of Jiangsu Province from October 2015 to December 2017.After exclusion criteria,251 patients with non-disabled ischemic cerebrovascular disease were enrolled in the study.General basic information(sex,age,height,weight,body mass index,smoking history,drinking history,diabetes history,hypertension history,stroke history,coronary heart disease history,first admission Blood pressure,clinical manifestations,duration of symptoms,time from onset to admission,admission and discharge NIHSS score and m RS score were measured.The ABCD2 and ABCD3-I scores were calculated)was collected for all patients.And the laboratory examination indexes(the results of fasting blood test were taken within the second day of admission,Including: White blood cell count,neutrophil count,serum creatinine,serum homocysteine,total cholesterol,triglyceride,high density lipoprotein,low density lipoprotein,lipoprotein(a),glycosylated hemoglobin)were calculated,imaging data(location and degree of vascular stenosis,location of ischemic lesions,number of lesions).One year after the onset of the disease,the patient was followed up by telephone for recurrence of cerebrovascular disease(see a doctor in the hospital and clearly diagnosed with a new acute cerebrovascular disease,including acute cerebral infarction and acute cerebral hemorrhage),29 of whom were not successfully followed up by telephone.The remaining 222 people completed the basic information input and telephone follow-up,9 died,of whom 4 died of non-cardiovascular and non-cerebrovascular diseases,and the remaining 5 died of recurrence of acute cerebrovascular diseases or related complications.A total of 218 people successfully completed the basic data and follow-up information input.It was divided into recurrence group and non-recurrence group.SPSS25.0 software was used for statistical analysis.Univariate analysis(t test,chi-square test,rank sum test)and multivariate logistic regression were used to analyze the risk factors closely related to the recurrence of non-disabled ischemic cerebrovascular events.The predictive value of ABCD scoring system for recurrent cerebrovascular disease in NICE patients within one year was studied by using the receiver operating characteristic curve.Results: There were 137 males and 81 females in 218 patients.there were 35 patients with new cerebrovascular diseases(all ischemic stroke),including 22 males and 13 females.There were 183 patients in the non-recurrence group,including 115 males and 68 females.The results of univariate analysis showed that the history of diabetes mellitus(42.9% vs 22.4%),hyperlipidemia(17.1% vs 6.6%),stroke(42.9% vs 19.7%)and,Neutrophil count>7×109/L(42.9% vs 22.4%),glycosylated hemoglobin>6.5%(68.6%vs 42.1%),smoking history and endogenous creatinine clearance rate have statistical significance.That is to say,compared with the non-recurrence group,the number of patients with diabetes,hyperlipidemia and stroke was higher,and the neutrophil count,glycosylated hemoglobin and endogenous creatinine clearance rate were higher in the recurrence group than in the non-recurrence group.There was no significant difference in sex,age,body weight,body mass index,drinking history,history of hypertension,history of coronary heart disease,white blood cell count,blood homocysteine,triglyceride,total cholesterol and high density lipoprotein cholesterol(P> 0.05).The above indicators with statistical differences were analyzed by multivariate analysis.The results showed that the history of stroke(OR3.530,95%CI1.445-8.620),neutrophil count>7×109/L(OR3.688,95%CI1.218-11.169),glycosylated hemoglobin>6.5%(OR3.170,95%CI1.445-8.620),passive smoking(OR0.133,95%CI0.033-0.544)and renal decompensation(OR0.198,95%CI0.052-0.760)were associated with the recurrence of non-disabled ischemic cerebrovascular events.Conclusion: 1.Previous history of stroke,neutrophil count >7×109/L,glycosylated hemoglobin >6.5%,passive smokers,renal decompensation(endogenous creatinine clearance 20-50 ml/(min ·1.73m2))and non-disabling ischemic cerebrovascular events are closely related to the recurrence of non-disabling ischemic cerebrovascular events.,For such patients,it is recommended to control the related risk factors,intensive treatment and regular follow-up.2.ABCD2 and ABCD3-I have certain predictive value for recurrent cerebrovascular disease in NICE patients after one year,and combined with the related imaging results can improve the predictive value of ABCD scoring system.