Analysis Of Correlation Between Triglyceride-glucose Index,bilirubin Blood Lipid Comprehensive Index And Early Neurological Deterioration In Patients With Mild Ischemic Stroke

Objective:It is to investigate whether the triglyceride-glucose index(TyG index),bilirubin blood lipid comprehensive index have the correlation in early neurological deterioration(END)in patients with mild ischemic stroke(MIS).Methods:148 acute MIS patients admitted by the Department of Neurology of the First Central Hospital of Baoding from January,2019 to December,2020 for the first time and within 72 h of onset were selected as the experiment group,and 80 healthy people who completed the physical examination were selected as control group.The degree of neurological deficits was assessed using the National Institute of Health Stroke Scale(NIHSS)score and divided into END and non-END groups based on neurological deterioration.The serological data of all the study population were collected,include the high density lipoprotein-cholesterol(HDL-C)、low density lipoprotein-cholesterol(LDL-C)、 triglyceride(TG)、 total cholesterol(TC)、total bilirubin(TBIL)、fasting venous blood glucose(FBG)to calculate the TyG index: ln[TG(mg/dl)×FBG(mg/dl)] /2,bilirubin blood lipid comprehensive index: LDL-C/(HDL-C + TBIL),TC/(HDL-C + TBIL),then the differences between the MIS and control groups were to be analyzed,and the differences between the END group and the non-END group were further studied.Finally,the receiver operating characteristic(ROC)curve was used to evaluate the prediction effect of END in MIS patients.All data collected were analyzed by SPSS26.0 statistical software,with P <0.05 considered statistically significant.Results:1.The levels of TyG index and bilirubin blood lipid comprehensive index in MIS group were higher than those of the control group,and the differences were statistically significant(P <0.05).2.TyG index and bilirubin blood lipid comprehensive index were higher in END group,with statistical significance(P <0.05).Multivariate regression analysis showed that the TyG index(OR 1.298,95%CI 1.013～1.663,P=0.039),LDL-C/(HDL-C+TBIL)(OR 1.053,95%CI 1.004～1.104,P=0.032),TC/(HDL-C+TBIL)(OR 1.045,95%CI 1.004～1.087,P=0.029),FBG(OR 1.184,95%CI 1.001～1.402,P=0.049)were independent risk factors for END occurrence in MIS patients.3.ROC curve of TyG index and bilirubin blood lipid comprehensive index to predict END in MIS patients: the area under the curve of 0.5 was considered as the reference boundary,and the area under the TyG index curve was 0.765,with the sensitivity of 61.5% and the specificity of 81.7%.The area under the LDL-C/(HDL-C+TBIL)curve was 0.724,with a sensitivity of 53.8% and a specificity of 87.2%.The area under the TC/(HDL-C+TBIL)curve was 0.730,with a sensitivity of 64.1% and a specificity of 78.9%.Conclusions:TyG index and bilirubin blood lipid comprehensive index are independent risk factors of END occurrence in MIS patients,which can predict whether a MIS patient may develop into END with relatively high sensitivity and specificity,it can be used as certain clinical guiding indexes.