Dynamic Changes of CRP,NLR and LER in Patients with Acute Cerebral Infarction and Their Prognostic Value
Objective To investigate the prognostic value of dynamic changes of C-reactive protein(CRP),neutrophil to lymphocyte ratio(NLR)and white blood cell to red blood cell count ratio(LER)in patients with acute cerebral infarction(ACI).Methods A total of 126 patients with ACI who visited the emergency department of the First People's Hospital of Shangqiu from February 2020 to February 2023 and underwent intravenous thrombolytic therapy in the hospital were selected.The patients were divided into a good prognosis group(94 cases)and a poor prognosis group(32 cases)according to the modified Rankin scale(mRS)score 90 days after onset.The changes of CRP,NLR and LER before thrombolysis,1 day after and 7 days after thrombolysis and mRS scores 90 days after onset were compared between the two groups.Cox regression was used to analyze the prognostic factors of patients with ACI intravenous thrombolysis.Spearman correlation was used to analyze the correlation between CRP,NLR and LER levels and mRS scores in ACI patients.Receiver operating characteristic(ROC)curve was used to analyze the prognostic value of CRP,NLR and LER on day 1 and day 7 after thrombolytic therapy in ACI patients.Results Repeated measurement ANOVA showed that CRP,NLR and LER had significant differences in time effect,intergroup effect and interaction effect between the two groups(P＜0.05).Simple effect analysis showed that the levels of CRP,NLR and LER 1 and 7 days after thrombolysis in the good prognosis group were lower than those in the poor prognosis group(P＜0.05).The distribution of mRS scores at 90 days after onset in the good prognosis group was better than that in the poor prognosis group(P＜0.05).Cox regression analysis showed that CRP,NLR and LER levels on day 1 and day 7 after thrombolysis were prognostic factors in patients with ACI intravenous thrombolysis.Spearman correlation analysis showed that CRP,NLR and LER levels 1 and 7 days after thrombolysis were positively correlated with mRS Scores 90 days after the onset of ACI patients(r=0.405,0.481,0.518,0.680,0.530,0.504,P＜0.05).ROC curve results showed that CRP,NLR,LER and their combined area under the curve(AUC)on day 7 after thrombolytic therapy were all greater than the AUC of each corresponding index and the combined index on day 1 after thrombolytic therapy.The AUC of each index combined to predict the prognosis of ACI patients with intravenous thrombolytic therapy on day 7 after thrombolytic therapy was the largest,0.856.Conclusion CRP,NLR and LER in patients with ACI intravenous thrombolytic therapy show a gradual downward trend with the improvement of the patient's condition,and are correlated with the patient's prognosis.The combined detection of these three indicators have a higher predictive value for the prognosis of patients with ACI intravenous thrombolytic therapy.
acute cerebral infarctionintravenous thrombolysiswhite blood cell to red blood cell count ratioprognosis
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