Volume 29, Issue 5, 2020
DOI: 10.24205/03276716.2020.1005
To Explore the Relationship Between NLR And the Severity of Acute Ischemic Stroke and The Clinical Prognosis of Patients Receiving Intravenous Thrombolytic Therapy
Abstract
Objective: To investigate the relationship between the neutrophil lymphocyte ratio (NLR) and the severity of acute ischemic stroke (AIS) and the clinical prognosis of patients receiving intravenous thrombolytic therapy.
Methods: A total of 120 AIS patients admitted to our hospital from January 2018 to January 2020 were selected. According to the "Scoring Standards for the Degree of Clinical Neurological Impairment in Chinese Stroke Patients", all patients were divided into mild AIS group with a score of 0-15 (N = 54), 16-30 were divided into moderate AIS group (n = 33), 31-45 were divided into severe AIS group (n = 33), and then according to the prognosis of intravenous thrombolysis, all patients were divided into prognosis Good group (n = 84), poor prognosis group (n = 36). The peripheral blood neutrophil count and percentage, lymphocyte count percentage, and NLR levels were compared between the three groups of patients with mild AIS, moderate AIS, and moderate AIS, and between the two groups with good prognosis and poor prognosis before treatment. Logistic regression analysis method, Pearson correlation analysis method, receiver operating characteristics (Receiver Operating Characteristics, ROC) area under curve (Area under curve, AUC) were used to analyze the severity of NLR and AIS disease and the clinical prognosis of patients after intravenous thrombolytic therapy Correlation.
Results: As the severity of AIS deepened, the neutrophil count, neutrophil percentage, and NLR in the peripheral blood of patients increased significantly, and the lymphocyte count and lymphocyte percentage decreased significantly (P <0.05); the peripheral blood of patients in the severe AIS group. The blood neutrophil count, neutrophil percentage, and NLR level were significantly higher than the mild AIS group and the moderate AIS group, and the lymphocyte count and lymphocyte percentage levels were significantly lower than the mild AIS group and the moderate AIS group (P <0.05). The results of multivariate logistic regression analysis showed that neutrophil count, neutrophil percentage, and NLR are independent risk factors that affect the severity of disease and poor clinical prognosis of patients after intravenous thrombolytic therapy. Lymphocyte count and lymphocyte percentage is a protective factor (P <0.05). The results of Pearson correlation analysis showed that there was a positive correlation between NLR and AIS patients' disease severity (P <0.05). The peripheral blood neutrophil count, neutrophil percentage, and NLR levels in the good prognosis group were significantly lower than those in the poor prognosis group, and the lymphocyte count and lymphocyte percentage levels were significantly higher than those in the poor prognosis group (P <0.05). The NLR predicts the clinical prognosis of AIS patients after receiving intravenous thrombolytic therapy, AUC=0.803, sensitivity 75.36%, specificity 77.52%, AUC (95%CI) =0.754 ~ 0.893 (P <0.05).
Conclusion: NLR is an independent risk factor that affects the severity of the disease in AIS patients and the poor clinical prognosis of patients after intravenous thrombolysis, and is positively correlated with the severity of the disease in AIS patients. It has a higher prognosis for patients receiving intravenous thrombolysis in AIS and high prediction accuracy.
Keywords
Neutrophil lymphocyte ratio; acute ischemic stroke; severity; intravenous thrombolysis; prognosis