Analysis Of The Correlation Between The Of Neutrophil-to-lymphocyte Ratio And Hemorrhagic Transformation In Acute Ischemic Stroke

Objective: Hemorrhagic transformation(HT)is one of the serious complications of acute ischemic stroke(AIS),which can develop spontaneously,or be induced by reperfusion therapy.Neutrophils to lymphocytes ratio(NLR)is currently considered to be an inflammatory marker independently related to the occurrence and development of cardio-cerebral vascular diseases.At present,researches with regard to the correlation between neutrophils to lymphocytes ratio and hemorrhagic transformation at domestic and foreign are still unclear.So,this study aims to explore the predictive effect of NLR on hemorrhagic transformation in patients with acute ischemic stroke and determine its best predictive value.Methods: Clinical data of 300 patients with acute ischemic stroke admitted to the Department of Neurology,Yijishan Hospital,Wannan Medical College from July 2019 to July 2020 were retrospectively collected.Patients were divided into HT group and non-HT group by whether symptomatic intracranial hemorrhage occurred.The clinical baseline characteristics of the two groups were compared,and the multivariate binary logistic regression methods were used to analyze the relationship between NLR and hemorrhagic transformation.ROC curve is used to determine the best predictive value of NLR for hemorrhagic transformation in patients with acute ischemic stroke.Results: A total of 280 patients met the inclusion criteria,of which 44 occurred hemorrhagic transformation,and the rate of hemorrhagic transformation was 15.71%.In the clinical baseline data analysis,the median of NLR in the hemorrhagic transformation group was 6.7,which was higher than 2.93 in the non-hemorrhagic transformation group {6.7(3.84-10.51)vs 2.93(2.0-4.52),p<0.0001},and the difference was statistically significant.Multivariate binary logistic regression analysis showed that the NLR(OR : 1.123,95%CI: 1.037-1.215,p=0.004)and neutrophil count(OR :1.214,95%CI:1.052-1.401,p=0.008)at admission were independently associated with HT.The area under the ROC curve(AUC)of neutrophils for predicting HT in AIS patients was 0.692(95% CI: 0.600-0.785),p<0.0001,with the best cut-off value was5.75,the sensitivity is 68.2%,and the specificity was 72.9%.The area under the ROC curve(AUC)of NLR predicting HT in AIS patients was 0.752(95%CI: 0.662-0.841),p<0.0001,with the best cut-off value was 4.96,sensitivity was 70.5%,and specificity was 79.7%.Conclusion: NLR is an independent predictor of hemorrhagic transformation in patients with acute ischemic stroke,and its best predictive value is 4.96,regardless of whether the patient receives reperfusion therapy.