Correlation Analysis Of CAR,LHR And Carotid Plaque Stability In Patients With Atherosclerotic Cerebral Infarction

Objective:This study was to explore the predictive value of C-reactive protein albumin ratio(CAR)and low-density lipoprotein cholesterol/high-density lipoprotein cholesterol ratio(LDL-HDL Ratio,LHR)in the stability of carotid plaque in patients with large artery atherosclerosis(LAA)type cerebral infarction.The formation of carotid unstable plaque can be detected by more simple and efficient medical means to better identify high-risk patients with acute ischemic stroke and reduce the incidence rate and mortality of acute ischemic stroke(AIS).Methods:Two hundred and ten patients who were hospitalized in the Department of Neurology of the First Affiliated Hospital of Dali University between October 2021 and September 2022 were selected,all of whom were well-established to have carotid plaques diagnosed by carotid angio-Graphic ultrasound.They were divided into stable plaque group(138 patients in total)and unstable plaque group(72 patients).The general clinical data of the enrolled patients were collected,and the name,gender,age,hypertension,diabetes mellitus,smoking,alcohol drinking were recorded.Blood biochemistry,blood routine,coagulation and other blood samples were collected to calculate the ratio of C-reactive protein and albumin to obtain car,and the ratio of low-density lipoprotein cholesterol and high-density lipoprotein cholesterol to obtain LHR.For the collected data,the statistical analysis will be completed using the statistical software SPSS version 27.0,which will test the level α Was set at 0.05,and differences were considered statistically significant at p < 0.05.Result:1.A total of 210 patients were selected in this study,138 patients were in the stable plaque group,72(52.2%)were male,66(47.8%)were female,and the mean age was in the range of 63.53 ± 10.52.There were 72 patients in the unstable plaque group,48(66.7%)males and 24(33.3%)females,with a mean age between 65.21 ± 10.76.Among the comparisons of general clinical data,the results of stable plaque group and unstable plaque group showed statistically significant differences in gender(p < 0.05),but not in the comparisons of age,hypertension,smoking history,drinking history(p > 0.05);2.For the comparison of hematological indexes,there were significant differences between stable plaque group and unstable plaque group in the comparison of CRP,ALB,HDL-C,LDL-C,Cys C,Hb A1c(p < 0.05),but not in the comparison of Neut%,Lymp%,Neut #,Lymp #,PDW,TC,TG,apo-A1,apo-B,LP(a),Hcy,UA,Crea,TBIL,FIB,FDP,D-D,FPG(p > 0.05).3.The difference between stable plaque group and unstable plaque group in the comparison of car and LHR was statistically significant(p < 0.01).4.Spearman correlation analysis was performed to explore the correlation between car and LHR with carotid plaque instability,and the results showed that car(r = 0.359,p < 0.01),LHR(r = 0.597,p < 0.01),and LHR were positively correlated with unstable carotid plaque,that is,car and LHR were elevated along with carotid plaque instability.5.For the variables with statistical significance at p < 0.05 in univariate analysis: gender,CRP,ALB,HDL-C,LDL-C,car,LHR,Cys C,Hb A1 c,binary logistic regression analysis was performed and the statistical results were car(or = 2.239,p < 0.05),LHR(or = 2.738,p < 0.05),indicating that car and LHR were independent risk factors for carotid plaque instability(p < 0.05).Logistic regression was fitted to the joint diagnosis equation logistic regression(P)=-5.234 + 0.829 * car + 1.43 * LHR.6.The ROC curve was drawn to analyze the predictive value of CAR,LHR,CAR combined with LHR for unstable carotid plaque in patients with large atherosclerotic cerebral infarction.The results showed that the optimal cut-off value of CAR for diagnosing unstable carotid plaque was 0.11,the sensitivity was 95.8%,the specificity was 50.0%,and the AUC was 0.718(95% CI: 0.651-0.785,p <0.01);The optimal cutoff value for diagnosing unstable carotid artery plaques in LHR is 1.65,with a sensitivity of 90.3%,a specificity of 67.4%,and an AUC of 0.863(95% CI: 0.815-0.911,p <0.01);The optimal cutoff value for the combined diagnosis of unstable carotid artery plaques by CAR and LHR is 2.82,with a sensitivity of 77.8%,a specificity of83.3%,and an AUC of 0.873(95% CI: 0.827-0.919,p <0.01).The combination of CAR,LHR,CAR,and LHR has certain predictive value for unstable carotid artery plaques,and the combination of the two has higher predictive value for unstable carotid artery plaques.Conclusion:1.CAR and LHR are positively correlated with unstable carotid artery plaques,meaning that CAR and LHR increase as the instability of carotid artery plaques increases.2.CAR is an independent risk factor for unstable carotid artery plaques.3.LHR is an independent risk factor for unstable carotid artery plaques.4.The combination of CAR,LHR,CAR,and LHR has certain predictive value for unstable carotid artery plaques,and the combination of the two has higher predictive value for unstable carotid artery plaques.