Relationship Between MHR And Severity Of Acute Ischemic Stroke And Prognosis Based On Propensity Score Matching

Objective:To explore the relationship between monocyte to high-density lipoprotein cholesterol ratio(MHR)and severity of acute ischemic stroke(AIS)and prognosis,and to provide a new idea for the diagnosis and treatment of AIS.Methods:A total of 637 patients with AIS in the Department of Neurology of Shaanxi Provincial People’s Hospital from January 2020 to January 2021 were prospectively collected.According to the different MHR levels on admission,patients with AIS were divided into high MHR group(MHR>0.51)and low MHR group(MHR≤0.51).The National Institutes of Health Stroke Scale(NIHSS)was used for all patients to assess the severity of the disease on admission,and the modified Mankin Scale(m RS)was used to assess the short-term prognosis of discharged patients after 3 months of follow-up.Etiological classification of patients with AIS was performed based on TOAST classification.AIS patients were divided into groups according to different onset time.SPSS 25.0 software was used for statistical analysis of the data.After adjusting for confounding factors by propensity score matching,the relationship between MHR level and severity of AIS and short-term prognosis was further investigated.Results:1.Before propensity score matching,there were significant differences in hypertension history,WBC,neutrophil,lymphocyte,ALB,TOAST classification and onset time between high MHR group and low MHR group(P<0.05).There was no significant differences in age,gender,history of diabetes,coronary heart disease,atrial fibrillation,smoking,drinking,TC,TG,LDL-C,Hcy and UA(P>0.05).After propensity score matching,138 pairs were successfully matched between the two groups,and the unbalanced covariates between the two groups reached equilibrium after matching(P>0.05).2.Comparison of NIHSS scores in different MHR level groups after matching:compared with the low MHR group(5.11±3.85),patients in the high MHR group had a higher level of NIHSS scores(6.47±4.85),and the difference was statistically significant(P= 0.011).3.Comparison of MHR levels in different NIHSS score groups after matching: there was significant difference in MHR levels between different NIHSS score groups(F=29.065,P<0.001).There was a position positive correlation between MHR and NIHSS score(r=0.337,P<0.001).4.Comparison of poor prognosis in different MHR level groups after matching:compared with the low MHR group(16.7%),the proportion of patients with poor prognosis in the high MHR group was higher(28.3%),and the difference was statistically significant(P=0.030).There was a position positive correlation between MHR and m RS score(r=0.263,P=0.001).5.Comparison of MHR levels in different TOAST classification groups: there was statistically significant differences in MHR level between different TOAST classifications(F=13.604,P<0.001),and the MHR of patients in the LAA group was higher than that in the SAO group and other groups.6.Comparison of MHR levels in different onset time groups: there was statistically significant difference in MHR between different onset time(F=10.104,P<0.001).Conclusion:1.After re-grouping by propensity score matching,the increase of MHR level was related to the severity in patients with AIS,which could be used as an indicator to judge the severity of AIS.2.After regrouping by propensity score matching,the increase of MHR level was related to the poor prognosis of AIS patients for 3 months,which could be used as an indicator to predict the poor prognosis of AIS in the near future.3.Compared with other subtypes of the TOAST classification,MHR may have a stronger correlation with LAA stroke.4.There was a certain correlation between MHR levels and different onset time of AIS patients.