Value of monocyte to high-density lipoprotein cholesterol ratio in predicting clinical prognosis after stent implantation for intracranial atherosclerotic stenosis
Objective To investigate the level of inflammation after interventional treatment in patients undergoing intracranial stent implantation by measuring the changes in the plasma levels of monocytes and high-density lipoprotein cholesterol(HDL-C)and monocyte to high-density lipoprotein cholesterol ratio(MHR)after stent implantation for intracranial atherosclerotic stenosis(ICAS)in high-altitude areas,as well as the causes of such changes and their value in predicting clinical prognosis.Methods The ICAS patients who were consecutively admitted to Qinghai Provincial People's Hospital,from June 10,2017 to March 1,2022 and underwent interventional treatment were enrolled,and all patients signed the informed consent.Clinical data and the data on interventional surgery were collected,and blood samples were collected before interventional treatment,within 72 hours after interventional treatment,and at 3 months after interventional treatment to measure the levels of monocytes and HDL-C.The above indicators were compared before and after interventional treatment,and such changes were analyzed in terms of their association with the site of cerebrovascular stenosis and NIHSS score.Results A total of 123 patients with severe ICAS who underwent intracranial stent implantation and had complete data were included.Compared with the data before surgery,there was a significant increase in the plasma level of monocytes at 72 hours after stent implantation[(0.64±0.21)×109/L vs(0.53±0.17)×109/L,P<0.001],while there was a significant reduction in the plasma level of monocytes at 3 months after stent implantation[(0.43±0.14)×109/L vs(0.53±0.17)×109/L,P<0.001].Compared with the data before surgery,there was no significant change in HDL-C within 72 hours after surgery[(0.93±0.21)mmol/L vs(0.93±0.18)mmol/L,P>0.005],while there was a significantly increase in HDL-C at 3 months after surgery[(1.05±0.21 mmol/L vs(0.93±0.18)mmol/L,P<0.001).There was no significant correlation between monocytes/HDL-C/MHR and NIHSS score before surgery and at 72 hours after surgery(P>0.005);there was no significant correlation between monocytes/HDL-C/MHR and NIHSS score before surgery and within 72 hours after surgery(P>0.005);at 3 months after surgery,monocytes and MHR were significantly negatively correlated with NIHSS score(r=-0.271,P<0.05;r=-0.320,P<0.005),while HDL-C was significantly positively correlated with NIHSS score(r=0.213,P<0.001).Conclusion Balloon dilatation and ischemia/reperfusion after intracranial stent implantation may cause inflammatory response in the body,thereby leading to increases in the level of monocytes and the value of MHR.Therefore,monocytes,HDL-C,and MHR may be used as predictive factors for the improvement in neurological defects in the convalescence stage after stent implantation.
万方数据
维普
