初诊缺血性脑卒中患者单核细胞/高密度脂蛋白胆固醇比值与预后关系的临床研究

Clinical study on the relationship between the monocyte/high-density lipoprotein cholesterol ratio and the prognosis of patients initially diagnosed with cerebral arterial thrombosis

目的探讨初诊缺血性脑卒中患者单核细胞/高密度脂蛋白胆固醇比值(MHR)与预后的关系。方法选择2018年7月~2019年12月萍乡矿业集团有限责任公司总医院收治的120例缺血性脑卒中患者,按照患者随访半年期间预后情况分成良好组(60例)和欠佳组(60例)。收集两组患者基本信息,开展血常规、血脂检查,计算其MHR。比较两组基本信息与临床相关指标,分析MHR与缺血性脑卒中患者预后的关系、MHR对缺血性脑卒中不良预后预测价值;根据MHR预测缺血性脑卒中患者不良预后ROC曲线分析最佳值,将120例患者分成两组,比较其预后情况。结果良好组神经功能缺损程度评分量表(NIHSS)评分和MHR值低于欠佳组,单核细胞数量少于欠佳组,高密度脂蛋白胆固醇(HDL-C)高于欠佳组,差异有统计学意义(P<0.05)。年龄(β=-0.42,OR=1.04,95%CI=1.02~1.08)、NIHSS评分(β=-0.45,OR=1.32,95%CI=1.18~1.45)、MHR(β=-0.56,OR=2.38,95%CI=1.11~5.24)是缺血性脑卒中患者预后主要影响因素。MHR预测缺血性脑卒中不良预后的ROC曲线下面积为0.694(95%CI=0.636~0.748,P<0.05),灵敏度、特异度分别为79.41%、58.33%,最佳临界值为0.48。MHR>0.48组患者再发脑卒中率、死亡率高于MHR≤0.48组,差异有统计学意义(P<0.05)。结论MHR值越高,初诊缺血性脑卒中患者神经损伤越严重,预后情况越差。

Objective To explore the relationship between the monocyte/high-density lipoprotein cholesterol ratio(MHR)and the prognosis of patients initially diagnosed with cerebral arterial thrombosis.Methods A total of 120 patients with cerebral arterial thrombosis admitted to General Hospital of Pingxiang Mining Group Co.,Ltd.from July 2018 to December 2019 were selected and divided into a good group(60 cases)and a poor group(60 cases)according to the prognosis of the patients during the half-year follow-up.The basic information of the two groups of patients was collected.Routine blood tests and blood lipid tests were carried out,and their MHR was calculated.The basic information and clinical indicators of the two groups were compared,and the relationship between MHR and the prognosis of patients with cerebral arterial thrombosis was analyzed,and the value of MHR in predicting the poor prognosis of patients with cerebral arterial thrombosis.Divide 120 patients into two groups according to the ROC curve for predicting the poor prognosis of patients with cerebral arterial thrombosis was the best value,and compare their prognosis.Results The national institute of health stroke scale(NIHSS)score and MHR values of the good group were lower than those of the poor group,the number of monocytes of the good group was less than that of the poor group,and the high density lipoprotein cholesterol(HDL-C)of the good group was higherr than that of the poor group,the differences were statistically significant(P<0.05).Age(β=-0.420,OR=1.04,95%CI=1.02-1.08),NIHSS score(β=-0.451,OR=1.32,95%CI=1.18-1.45),MHR(β=-0.562,OR=2.38,95%CI=1.11-5.24)were the main prognostic factors of the patients with cerebral arterial thrombosis.The area under the ROC curve of MHR predicting poor prognosis of ischemic stroke was 0.694(95%CI=0.636-0.748,P<0.05),the sensitivity and specificity were 79.41%and 58.33%,and the best cutoff value was 0.48.The recurrence rate and mortality of patients in the MHR>0.48 group were higher than those in the MHR≤0.48 group,and the differences were statistically significant(P<0.05).Conclusion The higher the MHR value,the more severe the nerve damage in patients initially diagnosed with ischemic stroke and the worse the prognosis.