EFFICACY OF LP-PLA2, OX40L, NLR AND PLR IN EVALUATING THE PROGNOSIS OF ACUTE ISCHEMIC CEREBRAL INFARCTION

Hongmei Zeng*, Lijun Xu*, #, Yeqing Zou**, Sixiang Wang*

* Department of Neurology, the Second Affiliated Hospital of Nanchang University, Nanchang, PR China - **Jiangxi Provincial Key Laboratory of Molecular Medicine, Nanchang, PR China

Objective: To analyse the efficacy of lipoprotein-associated phospholipase A2 (Lp-PLA2), serum OX40 ligand (OX40L), neutrophils/lymphocytes ratio (NLR), and platelet-lymphocytes ratio (PLR) in evaluating the prognosis of acute ischemic cerebral infarction.

Methods: One hundred and sixty eight patients with acute ischemic cerebral infarction treated in the neurology department of our hospital from February 2016 to December 2018 were selected. Patients were divided into a survival group (114 cases) and death group (54 cases) according to the patient’s death situation within 28 days. The ELISA method was used to detect the changes of Lp-PLA2 and OX40L levels in the two groups. The changes of NEUT, LYM and PLT were detected by the XS-800i blood analyser, and the NLR and NLR were calculated. Logistic regression analysis was used to analyse the poor prognostic factors of patients with ischemic cerebral infarction, while ROC curve was used to analyse the efficacy of each index in evaluating the prognosis of acute ischemic cerebral infarction.

Results: The age of the death group was significantly higher than that in the survival group (P<0.05). The NEUT count and PLT count in the death group were remarkably higher than those in the survival group (P<0.05), the levels of LYM count and uric acid in the death group were lower than those in the survival group, and the difference was statistically significant (P < 0.05). There was no significant difference in other indexes and complications between the two groups (P>0.05). The level of Lp-PLA2, OX40L, NLR, and PLR in the death group was significantly higher than that in the survival group, and the difference was statistically significant (P<0.01). Logistic regression analysis showed that uric acid was a protective factor for the good prognosis of patients, and age, Lp-PLA2, OX40L, NEUT counts and PLT counts were independent risk factors for patients with poor prognosis (P<0.05). The results of ROC curve analysis indicated that the area under the curve of Lp-PLA2, OX40L, NLR, and PLR in evaluating the prognosis of acute ischemic cerebral infarction was 0.816, 0.757, 0.793 and 0.748, respectively, which could be used as a specific index for the clinical evaluation of the prognosis of acute ischemic cerebral infarction.

Conclusion: The level of serum Lp-PLA2, OX40L, NLR, and PLR in patients with acute ischemic cerebral infarction significantly increased, and each index has a good predictive value for the prognosis of the patients. High-level Lp-PLA2, OX40L, NLR, and PLR suggests poor prognosis, which can provide theoretical reference for the clinical treatment of acute ischemic cerebral infarction.