| Objective:This study aims to explore the correlation between neutrophil to lymphocyte ratio,albumin,D-dimer and short-term prognosis of patients with cerebral venous sinus thrombosis(CVST).Methods:A retrospective analysis was performed on 161 CVST patients who were admitted to the Bethune First Hospital of Jilin University from January 2017 to December 2022.The gender,age,type of onset,risk factors,clinical characteristics,imaging characteristics and blood routine,D-dimer,albumin(ALB)in peripheral blood taken for the first time after admission were counted.The neutrophil-to-lymphocyte ratio(NLR)was obtained by calculating the ratio of absolute neutrophil to absolute lymphocyte values in blood routine.Patients was divided into better prognosis group(m RS scoreā„3)and worse prognosis group(m RS score<3)according to the modified Rankin Scale(m RS)score at discharge.All statistical analyses were performed with SPSS.23.0.Results:1.A total of 161 CVST patients were included in this study,including 72(44.7%)males and 89(55.2%)females,with a male to female ratio of 1:1.24.The median age of the patients was 37 years,with 38 patients(24%)in the acute stage,107 patients(66%)in the subacute stage,and 16 patients(10%)in the chronic stage.2.The better prognosis group was 122 cases(75.8%),the worse prognosis group was 39 cases(24.2%),including 34 patients(21.1%)with moderate to severe function outcome and 5 patients(3.1%)died.The average age of patients with better prognosis was 35 years,63(51.6%)female,27(22.1%)in the acute stage,81(66.4%)in the subacute stage,and 14(11.5%)in the chronic stage.The average age of patients with worse prognosis group was 41 years,26(66.75%)females,11(28.2%)patients in the acute stage,26(66.7%)patients in the subacute stage,and 2(5.1%)patients in the chronic stage.Results of univariate analysis: impaired consciousness(P<0.001),seizures(P=0.002),limb movement disorders(P=0.023),frontal lobe injury(P<0.001),parietal lobe injury(P=0.001),multiple lobar injuries(P=0.005),hemorrhagic cerebral infarction(P=0.013),cerebral hemorrhage(P=0.028),involvement of superior sagittal sinus(P=0.001),involvement of the transverse sinus(P=0.010),and involvement of the ethmoid sinus(P=0.012)were statistically significant in both groups.There were no significant differences in gender,age,type of onset,risk factors(oral contraceptives,pregnancy,hematological disorders),other clinical symptoms(headache,dizziness,visual impairment,aphasia,mental disorders),imaging characteristics(occipital lobe injury,temporal lobe injury,cerebral infarction,subarachnoid hemorrhage,involvement of inferior sagittal sinus,straight sinus,multiple venous sinus involvement)between the two groups.3.The comparison results of biochemical indicators showed that:(1)The absolute value of neutrophils(P=0.011),NLR(P<0.001),and D-dimer(P<0.001)levels were significantly higher in the worse prognosis group;(2)While the absolute value of lymphocytes(P=0.023)and albumin(P<0.001)were significantly lower.(3)Red blood cell(P=0.273),hemoglobin(P=0.053),mean red blood cell volume(P=0.380),mean red blood cell hemoglobin(P=0.074),mean red blood cell hemoglobin concentration(P=0.542),red blood cell distribution width(P=0.058),platelet(P=0.413),platelet volume(P=0.762),platelet distribution width(P=0.147),fibrinogen(P=0.367),homocysteine(P=0.466),folic acid(P=0.045),vitamin B12(P=0.905),uric acid(P=0.642),and LDL(P=0.957)had no statistically significant difference between the two groups.4.Thecorrelation analysis results showed that NLR(Rho = 0.446,P< 0.001)and D-dimer(Rho = 0.226,P = 0.004)were positively correlated with m RS score at discharge,while albumin(Rho =-0.166,P = 0.010)was negatively correlated with m RS score at discharge.5.Multivariate analysis showed that impaired consciousness(P< 0.001),frontal lobe injury(P< 0.001),and NLR(P = 0.013)were independent predictors of poor short-term prognosis of CVST.Albumin and D-dimer were only related with the short-term prognosis of CVST,but were not independent predictors.A receiver operating characteristic curve analysis showed that the area under the curve of NLR was 0.799(95 % CI: 0.726-0.871,P< 0.001),and the cut-off value was 4.016.The sensitivity and specificity were 89.7 %and 64.7 %,respectively.Conclusion:1.The levels of NLR,albumin and D-dimer in CVST patients are associated with the short-term prognosis.2.NLR,impaired consciousness,and frontal lobe injury are independent predictors for worse short-term prognosis in CVST patients. |
