Clinical Value Of Plasma Fibrinogen And Neutrophil/Lymphocyte Ratio In Evaluating The Severity Of Guillain-Barré Syndrome

Objective:To explore the clinical value of plasma fibrinogen（FIB）and neutrophil/lymphocyte ratio（NLR）in evaluating disease severity in patients with Guillain-Barrésyndrome（GBS）.Methods:A total of 109 GBS patients admitted to the Department of Neurology,The First Affiliated Hospital of Bengbu Medical College from January 2016 to December2020 were selected.and divided into mild group（n=66）and severe group（n=43）according to Hughes Functional Grading Scale（HFGS）before intravenous immunoglobulin（IVIG）.Age,gender,type of preinfection history,time from onset to immunotherapy,HFGS score before IVIG therapy,plasma albumin,triglyceride,C-reactive protein（CRP）,FIB,NLR between the two groups were compared.Through Multivariate binary logistic regression analysis,the independent risk factors affecting the severity of disease in GBS patients are identified,and the predictive value of clinically relevant indicators on the severity of disease in GBS patients is evaluated by drawing the area under the receiver operating characteristic curve.Spearman correlation analysis was used for the correlation between plasma FIB,NLR and HFGS score before IVIG therapy of GBS patients,P<0.05,indicating statistically significant differences.Results:There were no significant differences in gender,type of prodromal infection history,time from onset to IVIG therapy,neuroelectrophysiological classification,first symptom of involvement,alanine aminotransferase,aspartate aminotransferase,total cholesterol and platelet counts between mild group and severe group（all P>0.05）.There were statistically significant differences in age,albumin,triglyceride,C-reactive protein,FIB,D-dimer,neutrophil,lymphocyte,NLR and PLR between mild group and moderate and severe group（all P<0.05）.According to Multivariate binary logistic regression analysis,plasma FIB and NLR levels are independent risk factors for disease severity increase in GBS patients,and the OR values are 10.78 and 2.23,respectively（P<0.05）.Drawing the working curve of receiver shows that the area under the curve for NLR to predict severe GBS is 0.856.The best cut-off value was4.11,and the sensitivity and specificity were 72.1%and 90.9%,respectively.The area under the curve of plasma FIB for predicting severe GBS was 0.912,the optimal cut-off value was 3.61,and the sensitivity and specificity were 90.7%and 77.3%,respectively.The area under the curve of NLR combined with FIB for predicting severe GBS was0.951,the optimal cut-off value was 0.25,and the sensitivity and specificity were 81.8%and 93.0%,respectively.Spearman correlation analysis showed that plasma FIB and NLR were positively correlated with HFGS score of GBS patients before IVIG therapy（r_s=0.610,P<0.05;r_s=0.549,P<0.05）.Conclusion:1.Plasma FIB and NLR levels were independent risk factors for disease severity increase in GBS patients.2.Plasma FIB and NLR have good predictive value in evaluating the severity of disease in GBS patients,and their combination and mutual supplement can further improve their predictive value.3.Plasma FIB and NLR were positively correlated with HFGS score of GBS patients before IVIG therapy.The higher the level of plasma FIB and NLR,the more severe the disease of GBS patients.