MHR、GPR、CHR对急性缺血性脑卒中患者静脉溶栓后早期神经功能恶化的相关性研究

The Correlation Study of MHR, GPR and CHR on Early Neurological Deterioration in Patients with Acute Ischemic Stroke after Intravenous Thrombolysis

摘要: 目的：探讨单核细胞/高密度脂蛋白胆固醇比值(MHR)、γ-谷氨酰基转移酶与血小板比值(GPR)、C反应蛋白与高密度脂蛋白胆固醇比值(CHR)与急性缺血性脑卒中(AIS)患者静脉溶栓后早期神经功能恶化(END)的相关性。方法：回顾性收集纳入2021年1月至2023年9月在青岛大学附属医院接受静脉溶栓治疗的急性缺血性脑卒中患者为研究对象，根据END定义为入院后7天内任意一次美国国立卫生研究院卒中量表(NIHSS)评分较基线增加≥2分或运动项目评分较基线增加≥1分，将患者分为END亚组及非END亚组。比较END组与非END组基线临床资料的差异，根据入院NIHSS评分对神经功能损伤严重程度划分，分为轻度卒中组、中度卒中组和重度卒中组，比较三组间MHR、GPR、CHR水平差异，最后通过ROC曲线分析MHR、GPR和CHR对END的预测价值并将三个指标联合进行预测。结论：1) 入院时MHR、GPR、CHR值对急性缺血性卒中静脉溶栓患者发生早期神经功能恶化具有一定的预测价值。2) MHR、GPR、CHR水平越高，提示神经功能缺损越严重。

Abstract: Objective: This study aims to investigate the correlation between the monocyte to high-density lipoprotein cholesterol ratio (MHR), gamma-glutamyl transferase to platelet ratio (GPR), and C-reactive protein to high-density lipoprotein cholesterol ratio (CHR) with early neurological deterioration (END) in patients with acute ischemic stroke (AIS) following intravenous thrombolysis. Methods: A retrospective cohort of patients with AIS who received intravenous thrombolysis at the Affiliated Hospital of Qingdao University from January 2021 to September 2023 was analyzed. Patients were classified into END and non-END subgroups based on the occurrence of END, defined as an increase in the National Institutes of Health Stroke Scale (NIHSS) score by ≥2 points or an increase in motor score by ≥1 point within 7 days post-admission. Baseline clinical characteristics of the END and non-END groups were compared. Patients were further stratified into mild, moderate, and severe stroke groups based on initial NIHSS scores to compare the levels of MHR, GPR, and CHR among these groups. Receiver operating characteristic (ROC) curve analysis was conducted to evaluate the predictive value of MHR, GPR, and CHR for END, and the combined predictive value of these three indicators was assessed. Conclusion: 1) The MHR, GPR, and CHR values at admission have predictive value for early neurological deterioration in AIS patients undergoing intravenous thrombolysis. 2) Higher levels of MHR, GPR, and CHR indicate more severe neurological impairment.