Study On The Predictive Value Of NLR,PLR And PNR In Progressive Ischemic Stroke Of Large Atherosclerosis

Objective:To investigate the predictive value of neutrophil-to-lymphocyte ratio(NLR),platelet-to-lymphocyte ratio(PLR)and platelet-to-neutrophil ratio(PNR)in the progressive stroke of large atherosclerosis(PIS).Methods:The clinical data of 327 patients with large atherosclerotic cerebral infarction admitted to Fenyang Hospital of Shanxi Province from January 2021 to December 2021 were retrospectively collected.According to whether the disease progressed within 72 hours,they were divided into progressive stroke group(PIS group)and non-progressive stroke group(non-PIS group),and the clinical data of the two groups were compared.The influence of NLR,PLR and PNR on PIS was analyzed by binary logistic regression analysis,and the ROC curve was drawn to evaluate the predictive value of NLR,PLR and PNR for PIS in patients with large atherosclerotic cerebral infarction.Results:The comparison of clinical data between the two groups showed that the admitted systolic blood pressure,admitted diastolic blood pressure,admitted NIHSS score,white blood cell count,neutrophil count,NLR and PLR in the PIS group(56 cases)were higher than those in the non-PIS group(271 cases),and the differences were statistically significant(P < 0.05).The lymphocyte count and PNR in the PIS group were lower than those in the non-PIS group.The difference was statistically significant(P < 0.05).Binary logistic regression analysis showed that NLR(OR=1.150,95%CI: 1.048 ～ 1.261,P=0.003),PLR(OR=1.006,95%CI: 1.002 ～ 1.009,P=0.002)and PNR(OR=0.978,95%CI: 0.958 ～ 0.997,P=0.024)were independent influencing factors of PIS.ROC curve showed that the area under ROC curve for NLR prediction of PIS was 0.707(95%CI: 0.642 ～ 0.772,P<0.001),the optimal cutoff value was 3.14,the sensitivity was82.1%,and the specificity was 61.6%.The area under ROC curve for PLR prediction of PIS was 0.662(95%CI: 0.589 ～ 0.736,P<0.001),the optimal cutoff value was 138.50,the sensitivity was 73.2%,and the specificity was 57.2%.The area under ROC curve for PNR prediction of PIS was 0.604(95%CI:0.530～0.677,P=0.015),the optimal cutoff value was 44.28,the sensitivity was 64.3%,and the specificity was 59.4%.Conclusion:Elevated NLR and PLR were independent risk factors for PIS,and elevated PNR was an independent protective factor for PIS.NLR,PLR,and PNR all had predictive value in atherosclerotic progressive stroke.