| Objectives To investigate the correlation and predictive value of systemic inflammatory response index(SIRI)with the prognosis of acute anterior circulation cerebral infarction with endovascular treatment.Methods From October 2019 to October 2021,118 patients with acute anterior circulation ischemic stroke who received endovascular treatment were selected as the research subjects.Finally,110 patients were enrolled and completed the study.According to the median SIRI of 1.95×10~9/L,the patients were divided into low SIRI group(≤1.95×10~9/L)with 55 patients and high SIRI group(>1.95×10~9/L)with 55 patients.All enrolled patients collect general information such as age,sex,past history,and clinical indicators such as admission NHISS score,admission blood glucose,vascular occlusion location,intraoperative condition,etc.,and collect elbow vein blood test routine within 1 hour after the opening of the responsible blood vessel,and determine white blood cell count,neutrophil count,lymphocyte count,monocyte count,platelet count.Calculate SIRI=neutrophil count×monocyte count/lymphocyte count.The patients were followed up 90 days after discharge,and the prognosis of the patients was evaluated according to the m RS score.The t-test was used to compare the differences between the measurement data,and the chi-square test was used to compare the differences between the count data.Multivariate logistic regression analysis was used to determine whether SIRI was an independent risk factor for poor prognosis.The ROC curve of SIRI and admission NHISS score was drawn,and the area under the ROC curve of the two was compared by Z test to further evaluate the predictive ability and practical application value of SIRI for prognosis.Paired chi-square test and consistency test were used to evaluate SIRI and NHISS.The degree of calibration of the score.Results 1 The good prognosis rate of the low SIRI group was significantly higher than that of the high SIRI group,and the difference was statistically significant(P<0.05).Indicates that SIRI levels have an impact on prognosis.2 After adjusting for the interference of other factors,SIRI was still associated with poor prognosis of endovascular treatment of acute anterior circulation cerebral infarction(P=0.035).3 The area under the ROC curve(AUC)of SIRI and NHISS scores for predicting the prognosis of acute anterior circulation cerebral infarction by endovascular treatment were 0.764 and 0.833,respectively,the Z value was1.057,P=0.291,and the difference was not statistically significant(P<0.05).The AUC of NHISS score was slightly larger than that of SIRI,but the difference was not statistically significant(P>0.05).4 According to the principle of the largest Youden index,the prediction critical value is screened.The best cut-off point of SIRI is 1.94×10~9/L,and the best cut-off point of NHISS score is 16.5.When SIRI>1.94×10~9/L,its sensitivity was 82.1%,the specificity was 66.2%,and the Kappa value was 0.439.Compared with the prediction results of NHISS score,SIRI had slightly higher sensitivity and lower specificity,with paired chi-square test P=0.575 and P=0.091,and the difference was not statistically significant(P>0.05).Conclusions SIRI is an independent predictor of the prognosis of acute anterior circulation stroke with endovascular treatment.The higher the level of SIRI,the greater the proportion of poor prognosis.After external verification and related analysis,SIRI has a certain application value in actual clinical work.When the value is 1.94×10~9/L,it has higher sensitivity and specificity.Figure1;Table7;Reference 131... |
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