The Prediction Model Of Recurrent Cerebral Ischemia Was Established By Combining Platelet Function Detection

Objective:To investigate whether the results of platelet function test can be used as a predictive factor for the recurrence of cerebral ischemia in patients with cerebral infarction,and to establish a prediction model in combination with related predictive variables,so as to provide a reference for the drug scheme selection of patients with cerebral infarction.Methods:This study was designed as a prospective cohort study.Patients with primary acute cerebral infarction hospitalized in the department of neurology of the First People's Hospital of Changde City from March 2018 to August 2019 were selected.A total of 251 patients were included in the follow-up according to inclusion and exclusion criteria,and 216 patients were finally followed up.The relationship between HPR and recurrent ischemic events in patients with cerebral infarction was analyzed by Logistic univariate and multivariate analysis,and the predictive variables related to recurrent ischemic events in patients with cerebral infarction were screened.A predictive model was established by Logistic regression analysis,and the predictive value of the model was evaluated by ROC curve area(AUC).SPSS 22.0 software was used for data analysis.Results:1.A total of 216 patients were followed up.There were 182(84.26%)patients in the group without recurrent ischemic events,and 34(15.74%)patients in the group with recurrent ischemic events,including 29 patients with recurrent cerebral infarction and 5 patients with TIA.2.Logistic unifactorial analysis indicated that age,low-density lipoprotein cholesterol,creatinine,urea nitrogen,uric acid,white blood cell count,NIHSS,gender,history of diabetes,history of coronary heart disease,smoking history,and HPR had statistically significant differences between the group with recurrent ischemic events and the group without recurrent ischemic events(P<0.1).3.Logistic multivariate analysis indicated that the differences in age,NIHSS,white blood cell count and HPR between the group with recurrent ischemic events and the group without recurrent ischemic events were statistically significant(P<0.05).4.Logistic regression analysis indicated that NIHSS(OR=15.1635,95%CI:3.9680-71.5219),HPR(OR=4.1730,95%CI:1.4565-11.0367),white blood cell count(OR=3.9623,95%CI:1.1040-11.7290),and age(OR=1.0596,95%CI:1.0052-1.1331)all had good predictive value for recurrent cerebral ischemia events in patients with cerebral infarction.5.A prediction model was established according to the results of Logistic regression analysis.The area under the ROC curve of the prediction model was 0.8238(95%CI :0.7329-0.9146),the specificity was 0.8077,and the sensitivity was 0.7647,indicating that this prediction model has a good predictive value for recurrent cerebral ischemia events in patients with cerebral infarction.Conclusion:HPR assessed by platelet function was significantly correlated with recurrent ischemic events in patients with cerebral infarction.The combination of NIHSS,HPR,white blood cell count and age to establish a prediction model has a good predictive value for recurrent cerebral ischemia events in patients with cerebral infarction,which is helpful for clinical adjustment of treatment plans and early identification of patients prone to relapse.