Value of neutrophil-lymphocyte ratio and platelet-lymphocyte ratio in predicting cognitive impairment in patients with acute mild ischemic stroke

doi:10.3969/j.issn.1004-583X.2023.06.004

Abstract

Abstract:

Objective To investigate the value of neutrophil-lymphocyte ratio (NLR) and platelet-lymphocyte ratio (PLR) in predicting cognitive impairment at 3 months of acute mild ischemic stroke. Methods A total of 254 hospitalized patients with an initial ischemic stroke from December 2020 to May 2022 in Central Hospital of Jinzhou were selected as the study objects.NLR and PLR were measured at admission. Cognitive function was evaluated at 3 months of stroke by the Montreal Cognitive Assessment (MoCA). According to the MoCA score, patients were classified into post-stroke cognitive impairment group (PSCI group, n=101)and non-cognitive impairment group(NCI group, n =153). Logistic regression was used to screen the risk factors of PSCI. The predictive values of NLR and PLR in PSCI were analyzed by drawing the receiver operating characteristic (ROC) curves.Resultss There were significant differences in the median NLR (3.74[3.41, 5.15] vs 3.15[2.80, 3.82]) and PLR (131.78 [122.63, 149.56] vs 114.70[91.44, 134.52]) between PSCI group and NCI group (both P <0.05). Logistic regression showed that both NLR ( OR =1.437, 95% CI : 1.045-1.978, P =0.026) and PLR ( OR =1.011, 95% CI : 1.001-1.021, P =0.030) were risk factors for PSCI. The area under the curve (AUC) of NLR in predicting cognitive impairment at 3 months of stroke was 0.695(95% CI : 0.627, 0.763), with the cut-off value, sensitivity and specificity of 4.19, 43.6% and 82.4%, respectively. The AUC of PLR in predicting cognitive impairment at 3 months of stroke was 0.677(95% CI : 0.610, 0.745), with the cut-off value, sensitivity and specificity of 119.58, 79.2% and 59.5%, respectively.Conclusion NLR and PLR in the acute phase of ischemic stroke are independently correlated with cognitive impairment at 3 months of stroke, which can predict cognitive impairment at 3 months of stroke.

Key words: ischemic stroke, cognitive impairment, neutrophil-lymphocyte ratio, platelet-lymphocyte ratio

CLC Number:

R743.3

Xin Yanhong, Lang Guiyan, Chen Ziwei, Wang Dongyu. Value of neutrophil-lymphocyte ratio and platelet-lymphocyte ratio in predicting cognitive impairment in patients with acute mild ischemic stroke[J]. Clinical Focus, 2023, 38(6): 504-509.

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URL: https://huicui.hebmu.edu.cn/EN/10.3969/j.issn.1004-583X.2023.06.004

https://huicui.hebmu.edu.cn/EN/Y2023/V38/I6/504

Figures/Tables 3

Tab. 1 Comparison of baseline clinical data, NLR and PLR between groups

项目	NCI组( $n$ =153)	PSCI组( $n$ =101)	$t$ /χ²/ $Z$ 值	$P$ 值
年龄(岁)	60.50±8.605	62.99±7.138	-2.414	0.016
男性[例(%)]	93(60.8)	57(56.4)	0.476	0.490
受教育年龄≤9年[例(%)]	48(31.4)	50(49.5)	8.362	0.004
高血压[例(%)]	85(55.6)	64(63.4)	1.531	0.216
糖尿病[例(%)]	51(33.3)	38(37.6)	0.492	0.483
高同型半胱氨酸血症[例(%)]	46(30.1)	38(37.6)	1.570	0.210
HBP+DM +HHcy[例(%)]	5(3.3)	12(11.9)	9.583	0.007
高脂血症[例(%)]	70(45.8)	59(58.4)	3.904	0.048
吸烟史[例(%)]	69(45.1)	43(42.6)	0.157	0.692
饮酒史[例(%)]	42(27.5)	24(23.8)	0.430	0.512
心房颤动[例(%)]	9(5.9)	8(7.9)	0.405	0.525
冠心病[例(%)]	13(8.5)	14(13.9)	1.843	0.175
NIHSS^#	2.00(1.0,3.0)	3.0(1.0,4.0)	-1.720	0.085
卒中分型(TOAST)[例(%)]
大动脉粥样硬化	62(40.5)	47(46.5)
心源性栓塞	4(2.6)	2(2.0)
小血管闭塞	80(52.3)	47(46.5)	1.470	0.884
其他原因型	1(0.7)	1(1.0)
不明原因型	6(3.9)	4(4.0)
DMTS^△	10.05(7.10,16.55)	14.15(10.68,17.70)	-4.147	<0.01
≥2个梗死灶数量[例(%)]	54(35.3)	38(37.6)	0.143	0.705
关键部位梗死^▲[例(%)]	37(24.2)	42(41.6)	8.597	0.003
幕上/幕下梗死[例(%)]
幕上	67(43.8)	57(56.4)
幕下	70(45.8)	30(29.7)	6.569	0.037
幕上下	16(10.5)	14(13.9)
尿酸	295.60(241.80,359.20)	309.00(258.95,366.74)	-1.359	0.174
NLR	3.15(2.80,3.82)	3.74(3.41,5.15)	-5.267	<0.01
PLR	114.70(91.44,134.52)	131.78(122.63,149.56)	-4.784	<0.01

Tab. 1 Comparison of baseline clinical data, NLR and PLR between groups

项目	NCI组( $n$ =153)	PSCI组( $n$ =101)	$t$ /χ²/ $Z$ 值	$P$ 值
年龄(岁)	60.50±8.605	62.99±7.138	-2.414	0.016
男性[例(%)]	93(60.8)	57(56.4)	0.476	0.490
受教育年龄≤9年[例(%)]	48(31.4)	50(49.5)	8.362	0.004
高血压[例(%)]	85(55.6)	64(63.4)	1.531	0.216
糖尿病[例(%)]	51(33.3)	38(37.6)	0.492	0.483
高同型半胱氨酸血症[例(%)]	46(30.1)	38(37.6)	1.570	0.210
HBP+DM +HHcy[例(%)]	5(3.3)	12(11.9)	9.583	0.007
高脂血症[例(%)]	70(45.8)	59(58.4)	3.904	0.048
吸烟史[例(%)]	69(45.1)	43(42.6)	0.157	0.692
饮酒史[例(%)]	42(27.5)	24(23.8)	0.430	0.512
心房颤动[例(%)]	9(5.9)	8(7.9)	0.405	0.525
冠心病[例(%)]	13(8.5)	14(13.9)	1.843	0.175
NIHSS^#	2.00(1.0,3.0)	3.0(1.0,4.0)	-1.720	0.085
卒中分型(TOAST)[例(%)]
大动脉粥样硬化	62(40.5)	47(46.5)
心源性栓塞	4(2.6)	2(2.0)
小血管闭塞	80(52.3)	47(46.5)	1.470	0.884
其他原因型	1(0.7)	1(1.0)
不明原因型	6(3.9)	4(4.0)
DMTS^△	10.05(7.10,16.55)	14.15(10.68,17.70)	-4.147	<0.01
≥2个梗死灶数量[例(%)]	54(35.3)	38(37.6)	0.143	0.705
关键部位梗死^▲[例(%)]	37(24.2)	42(41.6)	8.597	0.003
幕上/幕下梗死[例(%)]
幕上	67(43.8)	57(56.4)
幕下	70(45.8)	30(29.7)	6.569	0.037
幕上下	16(10.5)	14(13.9)
尿酸	295.60(241.80,359.20)	309.00(258.95,366.74)	-1.359	0.174
NLR	3.15(2.80,3.82)	3.74(3.41,5.15)	-5.267	<0.01
PLR	114.70(91.44,134.52)	131.78(122.63,149.56)	-4.784	<0.01

Tab.2 Logistic regression analysis of influencing factors for PSCI

危险因素	回归系数	标准误	Wald χ²值	$P$ 值	$O R$ 值	95% $C I$
危险因素	回归系数	标准误	Wald χ²值	$P$ 值	$O R$ 值	下限	上限
年龄	0.022	0.033	0.435	0.510	1.022	0.957	1.091
受教育水平	0.424	0.302	1.969	0.161	1.528	0.845	2.762
HBP+DM+HHcy	1.300	0.646	4.046	0.044	3.668	1.034	13.014
高脂血症	0.360	0.292	1.525	0.217	1.433	0.809	2.538
NIHSS	-0.049	0.122	0.159	0.690	0.952	0.750	1.210
DMTS	0.037	0.049	0.561	0.454	1.037	0.942	1.142
关键部位梗死	0.714	0.323	4.886	0.027	2.042	1.084	3.846
幕上幕下梗死	4.364	0.113
幕下	0				1
幕上	0.160	0.471	0.115	0.734	1.173	0.467	2.951
幕上下	-0.050	0.484	1.076	0.300	0.606	0.235	1.563
NLR	0.363	0.163	4.968	0.026	1.437	1.045	1.978
PLR	0.011	0.005	4.737	0.030	1.011	1.001	1.021

Tab.2 Logistic regression analysis of influencing factors for PSCI

危险因素	回归系数	标准误	Wald χ²值	$P$ 值	$O R$ 值	95% $C I$
危险因素	回归系数	标准误	Wald χ²值	$P$ 值	$O R$ 值	下限	上限
年龄	0.022	0.033	0.435	0.510	1.022	0.957	1.091
受教育水平	0.424	0.302	1.969	0.161	1.528	0.845	2.762
HBP+DM+HHcy	1.300	0.646	4.046	0.044	3.668	1.034	13.014
高脂血症	0.360	0.292	1.525	0.217	1.433	0.809	2.538
NIHSS	-0.049	0.122	0.159	0.690	0.952	0.750	1.210
DMTS	0.037	0.049	0.561	0.454	1.037	0.942	1.142
关键部位梗死	0.714	0.323	4.886	0.027	2.042	1.084	3.846
幕上幕下梗死	4.364	0.113
幕下	0				1
幕上	0.160	0.471	0.115	0.734	1.173	0.467	2.951
幕上下	-0.050	0.484	1.076	0.300	0.606	0.235	1.563
NLR	0.363	0.163	4.968	0.026	1.437	1.045	1.978
PLR	0.011	0.005	4.737	0.030	1.011	1.001	1.021

Tab 3 Analysis of ROC curve analysis

危险因素	AUC	敏感度	特异度	约登指数	临界值	$P$ 值	95% $C I$
危险因素	AUC	敏感度	特异度	约登指数	临界值	$P$ 值	下限	上限
NLR	0.695	0.436	0.824	0.260	4.19	<0.01	0.627	0.763
PLR	0.677	0.792	0.595	0.387	119.58	<0.01	0.610	0.745

Tab 3 Analysis of ROC curve analysis

危险因素	AUC	敏感度	特异度	约登指数	临界值	$P$ 值	95% $C I$
危险因素	AUC	敏感度	特异度	约登指数	临界值	$P$ 值	下限	上限
NLR	0.695	0.436	0.824	0.260	4.19	<0.01	0.627	0.763
PLR	0.677	0.792	0.595	0.387	119.58	<0.01	0.610	0.745

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