The Correlation Between MHR,NLR And Severity And Short-term Prognosis Of Acute Ischemic Stroke

Objective:Recent studies have suggested that monocyte to high density lipoprotein ratio(monocyte to high density lipoprotein ratio,MHR)and neutrophils to lymphocytes ratio(neutrophils to lymphocytes ratio,NLR)may be prognostic markers of cardiovascular and cerebrovascular diseases.This article will discuss the value and interaction of MHR and NLR in predicting the severity and short-term prognosis of acute ischemic stroke.Methods:Selected 396 acute ischemic stroke(acute ischemic stroke,AIS)patients who were hospitalized in the Department of Neurology of the First Affiliated Hospital of Nanchang University from December 2019 to November 2020 as the AIS group,and randomly selected 210 hospitalized patients during the same period Patients with non-cerebral infarction served as the control group.Collect all patients’ age,gender,systolic and diastolic blood pressure at admission,smoking history,drinking history,hypertension,diabetes,hyperlipidemia,atrial fibrillation,coronary atherosclerotic heart disease and laboratory indicators(including white blood cell,Neutrophils,lymphocytes,monocytes,triglycerides,total cholesterol,low-density lipoprotein,high-density lipoprotein,fasting blood glucose,creatinine,uric acid,homocysteine).Calculate the MHR and NLR of each study subject,and collect the NIHSS score at admission and 7 days after the onset of the AIS group,and the m RS score at 3 months after the onset.According to the NIHSS scores of 0-5,6-15,≥16 at admission and 7days after onset,they were divided into mild,moderate,and severe AIS groups,and the MHR and NLR were compared between the three groups.According to the3-month prognosis,they were divided into a good prognosis group(m RS0-2 points)and a poor prognosis group(m RS≥3 points).Single factor and multivariate logistic regression were used to analyze the risk factors for the 3-month prognosis.Results:1.Compared with the control group,in the AIS group,smoking,drinking,hypertension,diabetes,hyperlipidemia,atrial fibrillation,systolic blood pressure,diastolic blood pressure,white blood cells,neutrophils,monocytes,triglycerides,high The differences in density lipoprotein,uric acid,homocysteine,MHR,and NLR were statistically significant(P<0.05),while differences in age,gender,coronary heart disease,lymphocytes,total cholesterol,low-density lipoprotein,fasting blood glucose,There was no statistically significant difference in creatinine(P>0.05).2.According to the NIHSS score at the time of admission,they were divided into274 people in the light AIS group,97 people in the medium cerebral infarction group,and 25 people in the severe cerebral infarction group.MHR increased sequentially in the three groups,and the difference between the two groups was statistically significant(P<0.05).NLR also increased sequentially in the three groups,and the differences between the two groups were statistically significant(P<0.05).3.According to the NIHSS score at the 7th day of onset,there were 323 patients in the light AIS group,48 patients in the medium AIS group,and 25 patients in the severe AIS group.There was no statistically significant difference in MHR between the light and medium AIS groups(P>0.05),while the comparison between the light or medium and heavy AIS groups was statistically significant(P<0.05).NLR increased sequentially in the three groups,but the NLR of the medium and severe AIS groups was not statistically significant(P>0.05);the difference between the mild and moderate and severe AIS groups was statistically significant(P<0.001).4.MHR was significantly positively correlated with the NIHSS score at admission(r=0.206,P<0.001),and was significantly positively correlated with the NIHSS score at 7 days of onset(r=0.511,P<0.001).There was a significant positive correlation between NLR and NIHSS scores at admission and 7 days after onset,with correlation coefficients of 0.511 and 0.558,respectively(P<0.001).5.Divided into a good prognosis group and a poor prognosis group according to the m RS at 3 months of onset.Using univariate and multivariate binary logistic regression analysis,the results showed that MHR,NLR,and NIHSS scores at admission were the-month poor prognosis of AIS patients.Independent risk factors(P<0.05).6.The receiver operating curve shows: the area under the curve for predicting the3-month prognosis of patients with acute ischemic stroke by MHR and NLR are0.646(95%CI: 0.584-0.708)and 0.882(95%CI: 0.848-0.916)).The area under the curve for MHR combined with NLR to predict the 3-month prognosis of patients with acute ischemic stroke was 0.898(95% CI: 0.867-0.929).Conclusions:1.MHR and NLR are positively correlated with the severity of acute ischemic stroke.2.High MHR,NLR and NIHSS score at admission are independent risk factors for the short-term prognosis of AIS patients.3.Compared with a single MHR or NLR index,MHR combined with NLR is more valuable in predicting the short-term prognosis of AIS patients.