Prediction Value Of NLR,PLR And HAR For Early Neurological Deteriorationf In Patients With Acute Cerebral Infarction

Objective:To investigate neutrophil to lymphocyte ratio(NLR)and platelet to lymphocyte ratio(NLR)in peripheral venous blood.PLR),hypersensitive c-reactive protein to albumin ratio(HAR)had significant effects on acute cerebral infarction,ACI)Predictive value of early neurological deterioration(END)in patients and its combined predictive value.Methods:A retrospective analysis was performed on 120 patients admitted to the Department of Neurology of the First Affiliated Hospital of Hebei North University,and the general and laboratory data of the two groups of patients were recorded.Univariate analysis and binary Logistic regression were used to analyze the influence of each index on the incidence of END.Patients with ACI were divided into END group(n =40)and non-end group(n =80)according to the progression of the disease.Patients with ACI were treated with the national institute of health stroke scale,An increase of 4points or more in NIHSS was defined as END.According to this,ACI patients were divided into END group and non-end group.The influence of NLR,PLR and HAR on the onset of END disease was analyzed by binary Logistic regression.Receive operating characteristic curve(ROC)was used to analyze the early predictive value of NLR,PLR and HAR to END.Results:1.In the END group and non-end group,binary Logistic regression analysis showed neutrophils(P=0.043),lymphocytes(P=0.035),platelets(P=0.010),hypersensitive C-reactive protein(P=0.002)and albumin(P<0.001),NLR(P=0.005),PLR(P=0.011)and HAR(P<0.001)were the influencing factors of END in ACI patients.2.ROC curve showed that the AUC of NLR was 0.669,the optimal diagnostic threshold was 4.16,the sensitivity was 55.0%,and the specificity was 78.8%.The AUC of PLR was 0.678,the best diagnostic threshold was 122.00,the sensitivity was 75.0%,and the specificity was56.3%.The AUC of HAR was 0.675,the optimal diagnostic threshold was0.085,the sensitivity was 52.5%,and the specificity was 82.5%.The combined AUC of the three was 0.753,the optimal diagnostic threshold was 0.270,the sensitivity was 70.0%,and the specificity was 70.0%.Conclusion:1.Neutrophils,platelets,hypersensitive C-reactive protein,NLR,PLR and HAR were independent risk factors for END in ACI patients,while lymphocytes and albumin were protective factors for END in ACI patients.2.NLR,PLR and HAR alone have diagnostic value in predicting the occurrence of END in ACI patients.3.The combination of NLR,PLR and HAR was more accurate in predicting END in ACI patients than NLR,PLR and HAR alone.NLR and PLR in combination with HAR may be valuable for early identification of patients with END.