Clinical value of common laboratory indexes in evaluating infarct size of ischemic stroke / 中国医师杂志

ABSTRACT

Objective:To explore the level changes of common laboratory indexes in patients with ischemic stroke (IS) with different infarct sizes and their clinical application value.Methods:The baseline data of 237 patients hospitalized in Lanzhou University Second Hospital from June 2019 to December 2020 and their laboratory indicators within 24 hours of admission were collected. The patients were divided into lacunar group ( n=80) and infarct group ( n=157) according to the infarct area. The experimental indexes and clinical data of the two groups were compared. Binary logistic regression was used to screen the independent influencing factors of infarct size and establish a joint diagnostic model. The receiver operating characteristic (ROC) curve and model calibration chart were used to verify the clinical application value of each index. Results:The levels of cholesterol (CHO)/high density lipoprotein (HDL), low density lipoprotein (LDL)/HDL, neutrophil count, Cystatin C (Cys C), phosphorus (PHOS), indirect bilirubin (IBIL), LDL, apolipoprotein (ApoB), homocysteine (HCY), D-dimer, smoking, drinking, overweight and arterial stenosis in the infarct group were higher than those in the lacunar group (all P<0.05), and the levels of apolipoprotein A Ⅰ (ApoAⅠ)/ApoB, ApoAⅠ and carbon dioxide (CO 2) in the infarct group were lower than those in the lacunar group (all P<0.05). ApoA Ⅰ/ApoB and CO 2 were independent protective factors of infarct size (all P<0.05); Cys C, PHOS and IBIL were independent risk factors of infarct size (all P<0.05). The combined prediction model of CO 2, PHOS, IBIL, ApoA Ⅰ/ApoB and Cys C has good prediction efficiency for infarct area, and the area under the curve (AUC) of combined diagnosis was 0.739. Conclusions:Laboratory indicators are closely related to the infarct size of IS. The model developed in this study have good clinical value, which provides a new basis for IS evaluation and early warning.