Research And Analysis Of Carotid Atherosclerotic Plaque And NLR、PLR、TAT In Patients With Acute Anterior Circulation Cerebral Infarction

Objective:To investigate the relationship between carotid atherosclerotic plaque,NLR,PLR,TAT and other related factors in patients with acute anterior circulation cerebral infarction.Methods:A total of 184 patients with medium,low or mixed echogenic plaques in the carotid artery from March 2021 to March 2022 in the Department of Neurology,Emergency and Physical Examination Center of Qinhuangdao First Hospital were collected.Among them,100 patients with acute anterior circulation cerebral infarction were included in the test group.Patients with non-acute cerebral infarction were 84 cases in the control group.The general information,inflammatory indicators,blood lipids,biochemistry,plaque characteristics,and contrast-enhanced ultrasound results of the two groups were collected and compared.Angiographic results were divided into 47 cases in the high degree of neovascularization group and 53 cases in the low degree of neovascularization group.The relevant data of the two groups were compared,and the factors with P<0.05 in the univariate analysis were included in the multivariate Logistic regression analysis for correction.The risk factors for the degree of plaque neovascularization were determined;at the same time,the receiver operating characteristic(ROC)curve was drawn to compare the effectiveness of each factor in predicting the degree of plaque neovascularization.The test group was grouped again by NIHSS score at admission,64 cases were divided into mild stroke group with ≤5,and 36 cases were divided into moderate and severe stroke group with>5.The relevant data of the two groups were compared,and factors with P<0.05 in univariate analysis were included in multivariate factors Correction was performed in the Logistic regression analysis to clarify the risk factors affecting the degree of neurological deficit in patients with acute anterior circulation infarction;at the same time,the receiver operating characteristic(ROC)curve was drawn to compare the effectiveness of various factors in predicting the degree of neurological deficit in patients with acute anterior circulation infarction.Results:The results of univariate analysis showed that BMI,smoking history,low-density lipoprotein,cholesterol,uric acid,neutrophil absolute value,platelet count,neutrophil to lymphocyte ratio(neutrophil to lymphocyte ratio,NLR),The platelet to lymphocyte ratio(PLR),degree of plaque neovascularization,plaque thickness,and plaque length were all higher than those in the control group,and the differences were statistically significant(P<0.05).Compared with the group with high degree of plaque neovascularization and low degree of plaque neovascularization,the proportion of smoking history,alcohol drinking history,NLR value and PLR value were higher,and the plaque length was longer,and the differences were statistically significant(P<0.05),but there was no significant difference in thrombin-antithrombin complexes(TAT)between the two groups.The results of multivariate Logistic regression analysis showed that after adjusting smoking history,drinking history,NLR,PLR,and plaque length,NLR(OR=5.870,95%CI:2.410～14.298,P<0.001),plaque length(OR=1.209,95%CI:1.081～1.354,P=0.001)is a risk factor affecting the degree of plaque neovascularization.The ROC curve results showed that the areas under the curve of NLR,plaque length,and multi-factor combination(NLR+plaque length)to predict the degree of plaque neovascularization were 0.890,0.781,and 0.933 respectively;It has the highest performance,when the cut-off value is 0.69,the specificity is 95.7%,and the sensitivity is 66%.Compared with the moderate-to-severe stroke group,the moderate-to-severe stroke group had higher proportion of smoking history,degree of plaque neovascularization,NLR value,and PLR value,and longer plaque length.Multivariate Logistic regression analysis showed that adjusted smoking After history,plaque neovascularization degree,NLR value,PLR value,and plaque length,NLR(OR=1.851,95%CI:1.162-2.946,P=0.009),plaque neovascularization degree(OR=5.988,95%CI:1.577～22.735,P=0.009)is a risk factor affecting the degree of neurological deficit.The results of the ROC curve showed that the areas under the curve of NLR,the degree of neovascularization in the plaque,and the combination of multiple factors(NLR+the degree of plaque neovascularization)in predicting the degree of neurological deficit in patients with acute anterior circulation infarction were 0.816,0.780,and 0.848,respectively;The single factor had the highest performance in predicting the degree of neurological deficit in patients,and when the cut-off value was 0.41,the specificity was 59.4%,and the sensitivity was 88.9%.Conclusion:1.NLR value and plaque length in patients with acute anterior circulation cerebral infarction are risk factors affecting the degree of carotid atherosclerotic plaque neovascularization,NLR value and plaque length can predict carotid atherosclerosis in patients with acute anterior circulation infarction Degree of plaque neovascularization.2.The NLR value and the degree of plaque neovascularization in patients with acute anterior circulation cerebral infarction are indicators that affect the degree of neurological deficit,and can reflect and predict the degree of neurological deficit to a certain extent.