Correlation Of The Red Cell Distribution Width To Platelet Count Ratio (RPR) With The Incidence And Volume Of Acute Cerebral Infarction

ObjectiveThe prediction of the severity of acute cerebral infarction(ACI)has always been a concern of the department of neurology.Simple and effective predictors are of great significance to the prediction.Therefore,this research aims to explore the correlation of the red cell distribution width to platelet count ratio(RPR)with the incidence and volume of ACI so as to provide certain help for the diagnosis of ACI,the prediction of the severity of the disease and its treatment.Methods119 hospitalized patients with ACI from January 2017 to July 2020 in the Sixth Medical Center of PLA General Hospital within 7 days of onset were included.All cases were confirmed as ACI by cranial MRI.99 patients with non-cerebral infarction served as the control group.The head MRI scan images of all patients within 72 hours of admission were studied.ImageJ was used to calculate the infarct volume.The infarct volume was obtained after adding the infarct area and multiplying by the distance between two adjacent layers.The researchers collected the blood routine and biochemical indicators of the fasting blood in the experimental group and the control group,calculated the red cell distribution width to platelet ratio(RPR),and collect their basic parameters such as age and sex and the risk factors of cerebrovascular diseases such as hypertension,diabetes,coronary heart disease,and stroke history.To analyze the correlation between RPR and infarct volume,119 patients with cerebral infarction were divided into 44 cases of lacunar infarction group(infarct volume<1.5cm3),31 cases of medium volume infarction group(infarct volume 1.5-3cm3),and 44 cases of large volume infarction group(infarct volume>3cm3)according to the size of the infarct volume.SPSS 20 was used to analyze the data.The measurement data conforming to the normal state were represented by the mean± standard deviation(x±s),and the t test is used to compare the two groups of measurement data.The enumeration data were expressed as a percentage,and the χ2 test was used for comparison between groups.According to the univariate logistic regression analysis,the independent variables with the result P<0.1 were included in the multivariate logistic regression analysis,and the confounding factors were adjusted to analyze the related factors of medium and large infarctions.The receiver operating curve(ROC curve)was used to calculate the best cut-off value,sensitivity,and specificity of the RPR level for the prediction of medium and large infarctions.ResultsRPR is related to the incidence of cerebral infarction.RPR predicted that the area under the ROC curve of ACI was 0.737(95%CI:0.672-0802)with the best cut-off value of 0.064,sensitivity of 50.4%,and specificity of 85.9%.The comparison of RPR among the three groups of infarct volume was statistically different(P<0.05);Spearman analysis showed that RPR was positively correlated with medium and large cerebral infarctions(r=0.443,P<0.01).PRP predicts that the area under the curve of medium and large infarctions was 0.765(95%CI:0.681～0.850 P<0.01).And the best cutoff value was 0.063 with the sensitivity of 68.0%,and specificity of 75.0%.Multivariate logistic regression analysis showed that elevated RPR level was a risk factor for medium and large cerebral infarctions(OR:2.228;95%CI:1.165-4.259 P<0.05).After adjusting confounding factors,and the risk of medium and large infarctions with RPR≥0.063 was 6.567 times that of RPR<0.063(95%CI:1.937-22.273 P<0.01).With the increase of RPR,the proportion of medium and large infarctions rose and was statistically significant.ConclusionRPR is related to medium and large cerebral infarctions,and high-level RPR has a certain value in the prediction of medium and large cerebral infarctions.