| Objective:To investigate the plasma neutrophil to lymphocyte ratio(NLR),platelet to lymphocyte ratio(PLR)and their combined indicators in patients with cerebral infarction and intravenous thrombolysis within 24 hours Predictive value for patient prognosis.Methods:Selected 128 patients who underwent intravenous thrombolysis for cerebral infarction at Chengde Central Hospital from August 2018 to August 2019.They are meeting the inclusion and exclusion criteria,and including 85 males(66.4%)and 43 females(33.6 %).Patients ranged in age from 43 to 85 years,with an average age of 63.72 years.All patients met the diagnostic criteria and recommendations for thrombolysis developed in the Chinese Guidelines for the Diagnosis and Treatment of Acute Ischemic Stroke 2018,and received a standard dose of alteplase(0.9 mg / kg)intravenously within 4.5 hours of the thrombolytic time window.After the alteplase intravenous thrombolysis treatment,the patient routinely took blood in the early morning of the next day and performed relevant blood tests such as blood routine(completed within 24 hours after admission).Relevant data(blood routine,blood uric acid,blood homocysteine,blood lipid,NLR,and PLR)were recorded after the laboratory test results were reported.Collect general clinical data(gender,age,history of cerebral infarction)based on medical records,and register the above data.Patients were followed up at 90 days after thrombolytic therapy and the patients were scored with a modified Rankin scale(m RS).According to the m RS score results,patients were divided into good prognosis group(m RS 0-2 points,75 cases)and poor prognosis group(m RS 3-6 points,53 cases).Statistical analysis was performed on various indicators(gender,age,history of cerebral infarction;blood routine,blood uric acid,blood homocysteine,blood lipid,NLR,PLR,etc.)in the two groups of data.The statistical results showed that there was a statistically significant difference between the two groups of patients in terms of age,triglyceride,uric acid,NLR,PLR,white blood cell count,absolute value and percentage of neutrophils,and absolute value and percentage of lymphocytes(P <0.05).After adjusting for age,triacylglycerol,and uric acid levels,the differences in NLR,PLR,white blood cell counts,absolute values and percentages of neutrophils,and absolute values and percentages of lymphocytes between the two groups were analyzed using binary logistic regression.The results suggest that: leukocyte count,absolute neutrophil count,neutrophil percentage,NLR and PLR are risk factors for poor prognosis after thrombolysis in cerebral infarction;absolute values and percentage of lymphocytes are protective prognostic factors.Receiver operating characteristic curve(ROC)was used to evaluate the sensitivity and specificity.NLR and PLR are combined to obtain the sensitivity and specificity of the combined index.Results:NLR and PLR were statistically significant in the binary logistic regression analysis.Comparison of NLR between good prognosis and poor prognosis groups: [3.23(2.24,5.48),5.10(3.00,9.94),P <0.001],PLR Comparison between good and poor prognosis groups: [128.10(97.20,171.30),160.19(113.69,265.74),P <0.001)].Further analysis of the NLR,PLR and their combined indicators using the ROC found that the NLR area under curve(AUC)for judging the thrombolytic prognosis of cerebral infarction = 0.7772,and the sensitivity was 69.8 when the optimal critical value was 3.755 %,Specificity is 74.7%.The prognosis of thrombolysis for cerebral infarction by PLR was AUC = 0.746.When the optimal cutoff was 145.055,the sensitivity was 64.2% and the specificity was 78.7%.The combined index of NLR and PLR for detecting thrombolytic prognosis of cerebral infarction was AUC = 0.781,when the critical value was 1.337,the sensitivity was 69.8%,and the specificity was 76.5%.Conclusion:NLR,PLR and their combined indicators as new-type inflammation indicators have a good predictive value for the poor prognosis of patients with cerebral infarction alteplase. |
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