Correlation between white blood cell count to mean platelet volume ratio and short-term prognosis of large artery atherosclerotic stroke / 国际脑血管病杂志

ABSTRACT

Objective To investigate the correlation between white blood cell count to mean platelet volume ratio (WMR) in peripheral blood and short-term prognosis of large artery atherosclerotic stroke (LAA).Methods From March 2015 to March 2018,patients with acute ischemic stroke admitted to the Department of Neurology,the Second Hospital of Tianjin Medical University were enrolled retrospectively.According to the TOAST etiological classification criteria,they were divided into LAA group and non-LAA group.According to the modified Rankin scale (mRS) score at 14 d after onset,they were divided into short-term good outcome group (0-2) and short-term poor outcome group (＞2).The clinical data,routine laboratory results and WlMR were collected and compared.Multivariatelogistic regression analysis was used to determine the independent risk factors for LAA and its short-term poor outcome.Receiver operating characteristic (ROC) curve was used to evaluate the predictive value of WMR for LAA short-term poor outcome.Results A total of 873 patients with acute ischemic stroke were enrolled,including 447 in the LAA group and 400 in the non-LAA group.WMR in the LAA group was significantly higher than that in the nonLAA group (0.96 ±0.16 vs.0.94 ±0.05;t =-2.397,P =0.017).Multivariate logistic regression analysis showed that WMR was not an independent risk factor for LAA (odds ratio 1.150,95％ confidence interval 0.999-1.325;P =0.052).WMR in the LAA short-term poor outcome group was significantly higher than that in the LAA short-term good outcome group (1.04 ± 0.129 vs.0.87 ± 0.146;t =-13.338,P ＜ 0.001).Multivariate logistic regression showed that WMR was an independent risk factor for LAA shortterm poor outcome (odds ratio 1.242,95％ confidence interval 1.025-1.504;P=0.027).ROC curve analysis showed that the optimal cutoff value of WMR in predicting LAA short-term poor outcome was 0.89,the area under the curve (AUC) was 0.799 (95％ confidence interval 0.755-0.843),the sensitivity was 85％,the specificity was 77.7％,the positive predictive value was 74.04％,and the negative predictive value was 86.93％.Conclusion The increased level of WMR are not independent risk factor for LAA,but are independent associated with poor short-term outcomes in LAA.