颈动脉超声定量参数联合MPV/PC比值、NLR对急性缺血性脑卒中患者预后不良的预测价值

摘要 目的：探讨颈动脉超声定量参数联合平均血小板体积（MPV）/血小板计数（PC）比值、中性粒细胞/淋巴细胞比值（NLR）对急性缺血性脑卒中（AIS）患者预后不良的预测价值。方法：选择2020年3月至2022年3月合肥市第二人民医院收治的97例AIS患者，所有患者均行颈动脉超声检查和血常规检查，获得颈动脉超声定量参数，计算MPV/PC比值、NLR。出院后90 d采用改良Rankin量表（mRS）评估患者预后，将患者分为预后不良组和预后良好组。受试者工作特征（ROC）曲线分析颈动脉超声定量参数、MPV/PC比值、NLR联合预测AIS患者预后不良的价值。结果：预后不良组动脉内膜中层厚度（IMT）、舒张末期血流速度（EDV）、MPV/PC比值、NLR大于预后良好组（P＜0.05），收缩期峰值血流速度（PSV）小于预后良好组（P＜0.05）。IMT、PSV、EDV、MPV/PC比值、NLR预测AIS患者预后不良的曲线下面积分别为0.751、0.710、0.693、0.769、0.771，联合IMT、PSV、EDV、MPV/PC比值、NLR预测AIS患者预后不良的曲线下面积为0.883，高于单独指标预测。结论：颈动脉超声定量参数联合MPV/PC比值、NLR在AIS患者预后不良评估中具有较高的预测价值。

Predictive Value of Carotid Artery Ultrasound Quantitative Parameters Combined with MPV/PC Ratio and NLR for Poor Prognosis in Patients with Acute Ischemic Stroke

ABSTRACT Objective: To investigate the predictive value of carotid artery ultrasound quantitative parameters combine with mean platelet volume (MPV)/platelet count (PC) ratio and neutrophil/lymphocyte ratio (NLR) for poor prognosis in patients with acute ischemic stroke (AIS). Methods: 97 AIS patients who were admitted to Hefei Second People''s Hospital from March 2020 to March 2022 were selected, all patients underwent carotid artery ultrasound and blood routine examination, carotid artery ultrasound quantitative parameters were obtained, and MPV/PC ratio and NLR were calculated. The prognosis of patients 90 days after discharge was evaluated by modified Rankin scale(mRS), patients were divided into poor prognosis group and good prognosis group. The value of carotid artery ultrasound quantitative parameters, MPV/PC ratio and NLR in predicting poor prognosis of AIS patients were analyzed by receiver operating characteristic (ROC) curve. Results: The intima-media thickness (IMT), end-diastolic blood flow velocity (EDV), MPV/PC ratio and NLR in poor prognosis group were higher than those in good prognosis group (P<0.05), the peak systolic velocity (PSV) was lower than that in good prognosis group (P<0.05). The areas under the curve of IMT, PSV, EDV, MPV/PC ratio and NLR in predicting poor prognosis of AIS patients were 0.751, 0.710, 0.693, 0.769 and 0.771 respectively, the area under the curve of combined IMT, PSV, EDV, MPV/PC ratio and NLR in predicting poor prognosis of AIS patients was 0.883, higher than the individual index prediction. Conclusion: Carotid artery ultrasound quantitative parameters combined with MPV/PC ratio and NLR have high predictive value in the evaluation of poor prognosis of AIS patients.