Clinical value of PHR in predicting poor prognosis after intravenous thrombolysis in patients with acute cerebral infarction
10.3969/j.issn.1673-4130.2025.16.005
- VernacularTitle:PHR预测急性脑梗死患者静脉溶栓后预后不良的临床价
- Author:
Fang CHENG
1
;
Yanhua NIU
;
Jinhui LIU
Author Information
1. 铜川市人民医院神经内科,陕西铜川 727000
- Keywords:
acute cerebral infarction;
intravenous thrombolysis;
platelet count to high-density lipopro-tein cholesterol ratio;
prognosis;
predictive value
- From:
International Journal of Laboratory Medicine
2025;46(16):1947-1952
- CountryChina
- Language:Chinese
-
Abstract:
Objective To explore the clinical value of the platelet count(PLT)to high-density lipoprotein cholesterol(HDL-C)ratio(PHR)in predicting poor prognosis after intravenous thrombolysis in patients with acute cerebral infarction(ACI).Methods A total of 304 patients with ACI who received intravenous thrombolytic therapy in this hospital from January 2021 to December 2023 were selected as the research sub-jects.According to the modified Rankin scale score at 6-month follow-up,the 304 patients with ACI were di-vided into the good prognosis group(n=216)and the poor prognosis group(n=88).Clinical data of all pa-tients were collected.The levels of PLT,HDL-C and PHR were compared between the two groups.The pre-dictive value of PLT,HDL-C and PHR for the prognosis of ACI patients was analyzed by using the receiver operating characteristic(ROC)curve.Binary Logistic stepwise regression analysis was used to explore the in-fluencing factors of prognosis in ACI patients.Results Compared with the good prognosis group,the HDL-C level in the poor prognosis group decreased,while the PLT level and PHR increased(P<0.05).The results of the ROC curve showed that the area under the curve(AUC)and 95%CI of PLT,HDL-C,and PHR for pre-dicting poor prognosis after intravenous thrombolysis in ACI patients was 0.829(0.784-0.874),0.743(0.693-0.788),and 0.918(0.873-0.968),respectively.The AUC of PHR in predicting poor prognosis af-ter intravenous thrombolysis in ACI patients was higher than that of PLT and HDL-C alone(Z=13.239,10.776,P<0.001).The proportions of National Institutes of Health Stroke Scale(NIHSS)score ≥8 points at admission,transformation of previous symptomatic hemorrhage,combined hypertension,and combined dia-betes in the poor prognosis group were all higher than those in the good prognosis group(P<0.05).The re-sults of binary Logistic stepwise regression showed that the NIHSS score at admission(OR=2.565,95%CI:1.292-5.094),the transformation of previous symptomatic hemorrhage(OR=2.073,95%CI:1.179-8.645),and PHR(OR=3.732,95%CI:2.037-6.839)were risk factors for poor prognosis in ACI patients(P<0.05).Conclusion PHR is expected to become an important reference index for predicting the prognosis of ACI patients after intravenous thrombolysis therapy.PHR,NIHSS score at admission,and the transforma-tion of previous symptomatic hemorrhage are all influencing factors for the prognosis of ACI patients after in-travenous thrombolysis therapy.