Neutrophil/lymphocyte ratio combined with phospholipase A2 can rapidly screen high-risk individuals for post-cir-culation ischemic stroke in the emergency department
Objective:To analyze the predictive value of neutrophil/lymphocyte ratio(NLR)combined with lipoprotein-associated phospholipase A2(Lp-PLA2)in the occurrence of post-circulation ischemic stroke in patients with simple dizzi-ness as the main complaint in the emergency department.Methods:The clinical data of 408 patients with simple dizziness as the main complaint in the emergency department were retrospectively analyzed.According to whether acute posterior circula-tion cerebral infarction occurred,the patients were divided into cerebral infarction group(117 cases)and non-cerebral infarction group(291 cases).The basic data and emergency admission data of the two groups were compared.Multivariate logistic regression was used to analyze the independent risk factors of posterior circulation ischemic stroke,and the receiver operating characteristic(ROC)curve was used to evaluate the predictive value of NLR combined with Lp-PLA2 for posterior circulation ischemic stroke in patients with simple dizziness in the emergency department.Results:There were significant differences in age,history of hypertension,diabetes mellitus and smoking between the two groups(all P＜0.05).Multivari-ate logistic regression analysis showed that age,history of hypertension and diabetes,NLR,Lp-PLA2 were independent risk factors for new posterior circulation ischemic stroke in patients with simple dizziness in emergency department.The area un-der the ROC curve of NLR for predicting posterior circulation ischemic stroke in patients with simple dizziness was 0.810(95％CI:0.763-0.856,P＜0.05),and the best cutoff point was 2.87,the sensitivity was 0.812,and the specificity was 0.732.The area under the ROC curve of Lp-PLA2 in predicting posterior circulation ischemic stroke in patients with simple dizziness was 0.840(95％CI:0.797-0.884,P＜0.05),the best cutoff point was 203.5,the sensitivity was 0.761,and the specificity was 0.804.The area under the ROC curve of NLR combined with Lp-PLA2 in predicting posterior circulation ischemic stroke in patients with simple dizziness was 0.851(95％CI:0.808-0.894,P＜0.05),the best cutoff point was 0.620,the sensitivity was 0.829,and the specificity was 0.794.Conclusion:NLR combined with Lp-PLA2 can quickly screen the high-risk group of posterior circulation ischemic stroke in patients with simple dizziness as the main complaint,so as to carry out active vascular evaluation and emergency cranial magnetic resonance to avoid missed diagnosis,especially in elderly patients with hypertension and diabetes.
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