Study On Early Neurological Deterioration And Long-term Prognosis Of Patients With Acute Cerebral Infarction By NLR And PLR

Objective To investigate the correlation between the ratio of neutrophils to lymphocytes(NLR)and the ratio of platelets to lymphocytes(PLR)in peripheral blood and the early neurological deterioration and long-term prognosis of patients with acute cerebral infarction,and to provide clinical help for the prevention of early neurological deterioration and the prevention and treatment of prognosis improvement in patients with acute cerebral infarction.Methods Data of 322 patients with acute cerebral infarction treated in the Neurology Center and Neurological Intensive Care Unit of the General Hospital of Ningxia Medical University from November 2018 to October 2019 were retrospectively analyzed.Peripheral white blood cell count,neutrophil count,absolute lymphocyte count and platelet count were recorded,and NLR and PLR values were calculated,respectively.Statistical analysis was performed.All patients were scored for neurological deficit according to NIHSS score or GCS score,and divided into deterioration group and non-deterioration group.Baseline data of the two groups were compared.Multivariate logistic regression was used to analyze the influencing factors of early neurological deterioration in patients with acute cerebral infarction.ROC curve was used to evaluate the predictive effect of NLR and PLR on the prognosis of patients with acute cerebral infarction.All patients were divided into good prognosis group and poor prognosis group according to modified Rankin Scale(mRS),and multivariate logistic regression analysis and ROC curve were performed.The NIHSS score on admission,NIHSS score on thethird day of admission,and the correlation between prognosis,NLR and PLR were analyed.Results(1)NIHSS score at admission of acute cerebral infarction was correlated with peripheral blood neutrophil count,lymphocyte count,platelet count,NLR and PLR(P<0.05),and NIHSS score on the third day of admission was correlated with peripheral blood leukocyte count,neutrophil count,lymphocyte count,NLR and PLR(P<0.05);(2)The levels of NLR and PLR in the early neurological deterioration group were significantly higher than those in the non-deterioration group(F=4.148,P<0.001),and the levels of NLR and PLR in the long-term poor prognosis group of cerebral infarction were significantly higher than those in the good prognosis group(F=4.682,P<0.001);(3)Multivariate logistic regression analysis showed that age,peripheral blood leukocyte count and neutrophil count were independent risk factors for poor prognosis of AIS;(4)In the ROC curve,the area under the NLR level curve was 0.791(95% CI:0.714-0.868),and the area under the PLR level curve was 0.655(95% CI: 0.561-0.749).Through comparison,the reference value of PLR for early neurological deterioration was higher than that of PLR.The area under the curve of NLR level was 0.791(95% CI: 0.714-0.868)and the area under the curve of PLR level was 0.618(95% CI: 0.543-0.693)to predict the longterm prognosis of patients with acute cerebral infarction.The comparison showed that the reference value of PLR for long-term prognosis was higher than that of PLR.Conclusions 1.Patient age,WBC count in peripheral blood and NEUT count are independent risk factors for poor prognosis of patients with acute cerebral infarction;2.NLR and PLR values at admission have certain predictive value for early neurological deterioration and long-term prognosis of patients with first acute cerebral infarction.