单核细胞与高密度脂蛋白胆固醇比值对急性缺血性脑卒中预后的预测价值

Predictive value of monocyte to high-density lipoprotein cholesterol ratio for prognosis of acute ischemic stroke

目的:探讨单核细胞与高密度脂蛋白胆固醇之比(monocyte to high-density lipoprotein cholesterol ratio,MHR)对急性缺血性卒中(acute ischemic stroke,AIS)患者3个月预后的预测价值。方法:回顾性纳入2019年7月至2020年9月海军军医大学第二附属医院神经内科住院的AIS患者313例,根据改良的Rankin量表评分(mRS),分为良好预后组(mRS≤2,n=260)和不良预后组(mRS>2,n=53)。采用多因素logistic回归评估MHR与不良预后之间的关系。采用ROC曲线评估MHR对AIS患者预后的预测价值。结果:与良好预后组相比,不良预后组有较高的MHR[(4.10±0.62)vs(5.25±0.85),P<0.001]。多因素logistic回归分析显示,MHR与3个月后功能预后独立相关(OR=2.690,95%CI 1.017~7.111,P=0.046)。ROC曲线分析显示,MHR的AUC为0.851(95%CI 0.788~0.913,P<0.001),最佳预测截断值为4.580,灵敏度为81.1%,特异度为79.2%。结论:MHR是AIS患者预后的有效独立预测因子。

Objective:To explore the predictive value of the monocyte to high-density lipoprotein cholesterol ratio(MHR)on the prognosis of patients with acute ischemic stroke(AIS)for three months.Methods:A total of 313 AIS patients hospitalized in the Department of Neurology,The Second Affiliated Hospital of Navy Medical University from July 2019 to September 2020 were retrospectively included.According to the modified Rankin Scale(mRS),313 patients were divided into good prognosis group(mRS≤2,n=260)and poor prognosis group(mRS>2,n=53).Multivariate logistic regression analysis was performed to evaluate the relationship between MHR and poor prognosis.The prognostic value of MHR in AIS patients was evaluated by ROC curve method.Results:Compared with the good prognosis group,the poor prognosis group had higher MHR[(4.10±0.62)vs(5.25±0.85),P<0.001].Multivariate logistic regression analysis showed that higher MHR(OR=2.690,95%CI 1.017-7.111,P=0.046)was independently associated with poor functional outcomes after 3 months.ROC curve analysis showed that the area under the curve(AUC)for MHR was 0.851(95%CI 0.788-0.913,P<0.001)and the best predictive cutoff value was 4.580,with a sensitivity of 81.1%and a specificity of 79.2%.Conclusions:MHR is an effective and independent predictor of poor outcomes in patients with AIS.