Changes And Clinical Significance Of NLR And PLR In Patients With Acute Cerebral Infarction Complicated With Type 2 Diabetes Mellitus

Cerebral infarction is a common vascular complication and the most important cause of death and disability in patients with diabetes mellitus.Cerebral infarction and diabetes mellitus are risks,both often exist in the clinic.The patients with cerebral infarction complicated with diabetes mellitus have an increasing trend.Diabetes mellitus and cerebral infarction as a common diabetic macrovascular complications,the pathogenesis is not yet fully clear,but that is believed to be related to low-grade chronic inflammation.Neutrophil to lymphocyte ratio（NLR）,platelet to lymphocyte ratio（PLR）are new markers of inflammation,which can more stably reflect the inflammatory status of the body.A large number of studies have showed that NLR and PLR play a significant role in the development and progression of cerebral infarction or diabetes mellitus,but there is relatively little research on cerebral infarction complicated with diabetes mellitus.And because the NLR and PLR indicators can be obtained in the routine examination items of the emergency department,finding out the clinical reference value for the patients with dcerebral infarction complicated with diabetes mellitus,it will be of great significance to our clinical medical workers.AIM:Through the retrospective analysis of the level change and relationship between NLR and PLR with disease,this research aims to investigate the pathophysiology mechanism and clinical significance of NLR,PLR in the patients with acute cerebral infarction complicated with type 2 diabetes mellitus,and provide certain theoretical basis for early clinical intervention and condition evaluation.Methods:126 patients with acute cerebral infarction who were hospitalized in the First Affiliated Hospital of Hebei North University’s Neurology from September 2018 to January 2020 and diagnosed by MRI were randomly selected.According to whether they have type 2 diabetes mellitus,these 126 patients were included into two groups:CIDM group（69cases of acute cerebral infarction complicated with type 2 diabetes mellitus,29 males and 40 females,the mean age was 61.02?7.50）.CI group（57 cases of acute cerebral infarction without diabetes mellitus,35 males and 22females,the mean age was 62.47?10.36）.According to the NIHSS score standards,the patients in the CIDM group and CI group were divided into mild defects（≤4 points）,moderate and severe defects（>4 points）.The CIDM group was divided into CIDM₁group（mild group of acute cerebral infarction complicated with type 2 diabetes mellitus,n=20）and CIDM₂group（moderate and severe group of acute cerebral infarction complicated with type 2 diabetes mellitus,n=49）.The group CI was divided into CI₁group（mild group of acute cerebral infarction without diabetes mellitus,n=18）and CI₂group（medium and severe group of acute cerebral infarction without diabetes mellitus,n=39）.In addition,60 healthy people who were examined at our physical examination center during the same period were selected as control group（C group）,31 males and 29 females,the mean age was 60.99?9.09.All the general clinical data and laboratory testing indicators were collected in detail,and performed statistical analysis.Results:1.Compared with C group,the NLR,PLR and hs-CRP levels in CIDM group and CI group were significantly increased;the NLR,hs-CRP levels were highest in CIDM group.Differences were statistically significant（P<0.05）.2.Compared with C group,the NLR and PLR levels of CIDM₁group and CI₁group were significantly increased;the NLR level of CIDM₁group was highest.Differences were statistically significant（P<0.05）.3.Compared with C group,the NLR,PLR and hs-CRP levels of CIDM₂group and CI₂group were significantly increased;the NLR and hs-CRP levels of CIDM₂group were highest.Differences were statistically significant（P<0.05）.4.The NLR,PLR and NIHSS scores were all positively correlated in CI group（r=0.393,P=0.003;r=0.347,P=0.008）.5.The NLR,PLR and NIHSS scores were all positively correlated in CIDM group（r=0.431,P<0.001;r=0.319,P=0.005）.6.Mutiple logistic regression analysis showed that NLR was an independent risk factor for acute cerebral infarction complicated with type2 diabetes mellitus（OR=1.805,P<0.05）.Conclusion:1.Acute cerebral infarction patients complicated with type 2 diabetes mellitus have higher NLR,PLR and hs-CRP levels.2.The levels of NLR and PLR are associated with the occurrence of acute cerebral infarction.3.The levels of NLR and PLR are positively correlated with the NIHSS score in CIDM group.That suggests that NLR and PLR can be used as a simple clinical indicator to evaluate the severity of neurological deficits.4.The high level of NLR is an independent risk factor for acute cerebral infarction complicated with type 2 diabetes mellitus.And it has certain reference value for the diagnosis and prognosis assessment of acute cerebral infarction patients complicated with type 2 diabetes mellitus.5.PLR may not be a risk factor for acute cerebral infarction patients complicated with type 2 diabetes mellitus,however,more researches are needed to explain its role in patients with diabetes mellitus.