Correlation Analysis Of MPV/PC Ratio Combined With TEG And Short-term Prognosis Of Acute Ischemic Stroke

Objective:To explore the relationship between the ratio of mean platelet volume to platelet count(MPV/PC)combined with thrombelastography(TEG)and the short-term prognosis of acute ischemic stroke(AIS).Methods:A total of 62 patients diagnosed with AIS admitted to the Department of Neurology,Shaanxi Provincial People’s Hospital from August 2019 to November 2020 were enrolled.According to the modified Rankin Scale(m RS)score,the functional outcome at 3 months after discharge was divided into good group(0 ≤ m RS score ≤ 2 points,n = 38 cases)and poor group(2 <m RS score ≤ 6,n=24 cases).The blood routine within 24 hours of admission and the blood routine and TEG on the 7th day of admission were tested for all included subjects,and the MPV/PC ratio was calculated based on the mean platelet volume(MPV)and platelet count(PC)in the blood routine.Binary logistic(multivariate)regression analysis was used to determine which factors contributed to poor short-term outcomes of AIS patients,and the receiver operating characteristic(ROC)curve was used to evaluate which index had the best predictive value for the short-term poor prognosis.Results:1.Compared with the good prognosis group,the general clinical data and laboratory data in the poor prognosis group: the National Institutes of Health Stroke Scale(NIHSS)score and classification,low-density lipoproteins cholesterol(LDL-C),D-Dimer(DD),Homocysteine(Hcy)levels were significantly increased(P<0.001,0.001,0.034,0.039,0.045),while the other indicators were not significantly different between the two groups.2.Compared with the good prognosis group,the lymphocyte count and PC in the poor prognosis group within 24 hours of admission were significantly reduced,and MPV,MPV/PC were significantly increased,and the differences were statistically significant(P<0.05);PC was significantly decreased on the 7th day of admission,while MPV and MPV/PC were significantly increased,and the differences were statistically significant(P<0.05).3.The PC,MPV,MPV/PC within 24 hours of admission and the 7th day of admission were compared.On the 7th day of admission,PC was increased,while MPV and MPV/PC were decreased,the difference was statistically significant(P<0.001).4.Compared with the good prognosis group,the R value and K value of TEG parameters in the poor prognosis group were striking decreased(P=0.002,0.002),while the α angle,MA value,and CI value were striking increased(P=0.004、<0.001、0.01);In the poor prognosis group,the clopidogrel resistance(CR)rate was significantly increased(P=0.027),while there was no significant difference in aspirin resistance between the two groups(P=0.509).5.Pearson correlation analysis between platelet(PLT)parameters and TEG parameters showed that MPV was weakly and positively associated with MA(r=0.252,P=0.049),while the other indicators were not obvious association.6.The correlation analysis between NIHSS score and TEG parameters showed that NIHSS score was negatively and weakly correlated with R value and K value(r=-0.256,P=0.045;r=-0.317,P=0.012),and was positively and weakly correlated with MA value and α angle(r=0.266,P=0.037;r=0.288,P=0.023).7.Multifactor logistic regression analysis(adjusting for other confounding factors)showed that NIHSS score,MPV,MPV/PC within 24 hours of admission,and MPV,MPV/PC and MA on the 7th day of admission were independent risk factors for poor short-term prognosis of AIS patients.8.ROC curve analysis showed that the best cut-off values of MPV/PC within 24 hours of admission,MPV/PC,MA,MPV/PC combined with MA at 7 days after admission for predicting short-term poor prognosis were 0.055,0.047,63.050,-0.581,respectively;The area under ROC curve(AUC)and 95% confidence interval(CI)were 0.804(95%CI0.685～0.923),0.781(95%CI 0.664～0.898),0.772(95%CI 0.652～0.893),0.893(95%CI0.815～0.97),respectively;The sensitivity were 0.750,0.750,0.667,0.875,respectively;The specificity were 0.842,0.737,0.816,0.737,respectively.Conclusion:1.MPV was positively and weakly correlated with MA value;NIHSS score was negatively and weakly correlated with R value and K value,and was positively and weakly correlation with α angle and MA values.2.NIHSS score,MPV,MPV/PC within 24 hours of admission,MPV,MPV/PC and MA on the 7th day of admission were independent risk factors for poor short-term prognosis of AIS patients.3.MPV/PC within 24 hours of admission,and MPV/PC,MA,MPV/PC combined with MA on the 7th day of admission all have a certain predictive value for the short-term prognosis of AIS patients,and the predicted value of MPV/PC combined MA value was the best.