Correlation Between Neutrophil/Lymphocyte Ratio And Clinical Prognosis Of Acute Ischemic Stroke

Objective:To analyze the correlation between neutrophil/ lymphocyte ratio(NLR)and the clinical prognosis of acute ischemic stroke(AIS).To explore the prognostic value of NLR in AIS patients,and to provide a reference for early assessment of patients with acute cerebral infarction.Methods:A total of 191 patients with AIS were included in this study.Baseline clinical data were collected for all patients including blood routine and hs-CRP at admission.Blood lipid,uric acid,albumin and other related indicators were collected in the morning of the next day(from 5 to 6 o ’clock).Collecting general clinical data such as age and gender and risk factors of cerebrovascular diseases such as hypertension,diabetes,smoking and drinking,etc.The NLR value was calculated according to the test results.When patients were admitted to the hospital,they were assessed by the National Institute of Health Stroke Scale(NIHSS)to evaluate the severity of ischemic stroke.The patients were followed up for 3 months after stroke,and the prognosis was evaluated by the Modified Rankin Scale Score(MRS).MRS ≥3 was considered as a poor prognosis.Firstly,the patients were divided into four groups by quartile method according to the NLR.The Jonckheere-Terpstra test was used to test the trend between the incidence of AIS adverse events and the increase of NLR.At the same time,the best cut-off value of NLR to distinguish the good prognosis and the bad prognosis of AIS patients was calculated by the receiver operating curve(ROC)curve.Finally,the independent risk factors of poor prognosis at 3-months after discharge were determined by binary logistic regression equation.Results:We divided the NLR levels from low to high using the quartile method to divide patients into 4 groups,each group containing 48,48,48,47 patients.As the NLR value increased,the incidence of poor prognosis increased with each group,and there were significantly statistical differences between groups(P <0.001).Then the ROC curve calculated that the NLR value of 2.704 is the best cut-off value to distinguish between good prognosis and bad prognosis.According to the best cut-off value,the study population was divided into high NLR group and low NLR group.The low group(NLR ≤2.704)included 82 patients,and 19 patients had a poor prognosis at 3-months after discharge.The incidence rate was 18.4%.The high group(NLR> 2.704)including 109 patients and 84 patients had a poor prognosis,the incidence rate was 81.6%.There was a significantly statistical difference between two groups(P<0.001).Finally,we obtained a binary multivariate logistic regression analysis to conclude that NLR is an independent risk factor of prognosis in patients with AIS(OR,1.672,95% CI,1.306-2.066,P=0.011),the higher the NLR value,the worse the prognosis of AIS patients.Conclusion:This study evaluated the relationship between baseline NLR and prognosis at 3-months after discharge in AIS patients.NLR was found to be an independent predictor of prognosis at 3-months in patients with AIS.Choosing NLR as a target for inflammatory markers may provide new strategies and methods for future treatment of AIS patients and improvement of prognosis.