Predictive Value Of MPVLR And MHR On The Severity Of Acute Cerebral Infarction

Objective: Discuss and analyze the predictive value of mean platelet volume to lymphocyte ratio(MPVLR)and monocyte/high density lipoprotein ratio(MHR)for the severity of acute cerebral infarction.Methods: A retrospective analysis of 265 patients with acute cerebral infarction who were hospitalized in the Neurology Department of the First Affiliated Hospital of Bengbu Medical College from January 2019 to October 2020.Before treatment,they were divided according to the National Institutes of Health Stroke Scale(NIHSS)score.They were the mild group(NIHSS score ≤ 5 points,n=164)and the moderate-to-severe group(NIHSS score> 5 points,n=101).(1)Detect general clinical data and laboratory related indicators of the two groups of patients,calculate MPVLR and MHR respectively,and perform statistical analysis between the groups;(2)Multivariate Logistic regression analysis of independent risk factors for the severity of acute cerebral infarction,using receiver operating characteristic curve(Received operating characteristic curve,ROC)to evaluate the impact of MPVLR,MHR and their combined indicators on the severity of acute cerebral infarction at admission Predictive value;(3)Using the MPVLR and MHR levels as the standards,the quartiles were used to divide the enrolled persons into 4 groups,and the Jonckheere-Terpstra test was used to analyze the trend among the groups to determine the incidence of moderate to severe acute cerebral infarction Trending relationship with MPVLR and MHR levels.P<0.05 indicates that the difference is statistically significant.Result:(1)Comparison and analysis of general clinical data between the two groups showed that the difference was not statistically significant(P>0.05);(2)The comparison of laboratory indicators between the two groups showed:medium-recombinant MPVLR,MHR,white blood cell count,MPV,monocyte count,D-dimer,neutrophil count,all greater than those of the mild group;medium-to-severe group lymphocyte count,high Density lipoprotein is lower than the mild group,the difference is statistically significant(P<0.05);(3)Logistic multivariate regression analysis showed that the independent risk factors for the severity of acute cerebral infarction were MPVLR,MHR and neutrophil count level at admission(P<0.001);(4)The ROC curve shows that the area under curve(AUC)of MPVLR for predicting the severity of acute cerebral infarction is 0.909(95%CI: 0.872-0.945),the best cut-off value is 6.619,and the sensitivity,specificity and Youden index are respectively 89.1%,82.3%,0.714;MHR predicts the severity of acute cerebral infarction with AUC of 0.866(95%CI: 0.818-0.913),the best cut-off value is 0.648,sensitivity,specificity and Youden index are: 77.2%,90.9%,0.681;The AUC of MPVLR combined with MHR to predict the severity of acute cerebral infarction is0.934,the best cut-off value is 0.319,and the sensitivity,specificity and Youden index are: 94.1%,84.8%,0.788,respectively;(5)Using the MPVLR and MHR levels as standards,the quartiles were used to divide the enrolled persons into 4 groups,and the Jonckheere-Terpstra test was used to analyze the trend among multiple groups.According to the MPVLR grouping,each subgroup(Q1-Q4)includes 66,66,67,and 66 patients,respectively.The proportion of patients in the moderate to severe group in each subgroup is: 3.03%,9.09%,56.72%,83.33%,respectively.The results showed that the incidence of cerebral infarction in the moderate to severe group increased with the increase of MPVLR level,and there were significant differences between the subgroups,with obvious statistical significance(P<0.001);according to the MHR grouping,each subgroup(Q5-Q8)Including 66,67,66,and 66 patients,the proportions of patients in the moderate to severe group in each subgroup were 3.03%,16.42%,50%,and 83.33%respectively.The results showed: the incidence of cerebral infarction in the moderate to severe group With the increase of MHR level,there are significant differences between subgroups,which are statistically significant(P<0.001).Conclusion:1.MPVLR,MHR,and neutrophil count are independent risk factors for judging the severity of acute cerebral infarction;2.The levels of MPVLR and MHR at admission have a certain predictive value for the severity of acute cerebral infarction,and have certain value for clinical identification of high-risk patients,and then provide a basis for providing more reasonable treatment and rehabilitation plans.