NAR,MHR and early neurological deterioration after intravenous thrombolysis in acute ischemic stroke patients

DAI Min; FU Jitong; JI He; WANG Tiantian; ZHANG Benjun; SUN Guangming; GUAN Min; ZHANG Jinping

doi:10.3969/j.issn.1671-2897.2025.06.019

Abstract：Objective To explore the correlation between NAR,MHR and early neurological deterioration(END)after intravenous thrombolysis in patients with AIS.Methods A total of 110 AIS patients who underwent intravenous thrombolysis from January 2022 to June 2024 were selected.According to the END occurrence,the patients were divided into the END group(n=21)and the non-END group(n=89).Neutrophil count,monocyte count,apo A1,HDL-C were detected,and NAR and MHR were calculated.The predictive value of NAR and MHR for END after intravenous thrombolysis in AIS patients was evaluated by the receiver operating characteristic curve.The influencing factors of END after intravenous thrombolysis in AIS patients were analyzed by multivariate Logistic stepwise regression.Results The levels of neutrophils,monocytes,NAR and MHR in the END group were higher than those in the non-END group,while apo A1 and HDL-C were lower(P<0.05).The AUC(95%CI)of NAR and MHR for predicting END after intravenous thrombolysis in AIS patients were 0.842(0.795～0.891)and 0.758(0.704～0.802)respectively.The AUC(95%CI)of the combined prediction of NAR and MHR was 0.904(0.856～0.955).Increased time from onset to thrombolysis(OR=1.728,95%CI:1.342～2.225),high NIHSS score(OR=2.399,95%CI:1.546～3.721),elevated NAR(OR=2.776,95%CI:1.200～6.423),and elevated MHR(OR=3.086,95%CI:1.557～6.117)were independent risk factors for END in AIS patients(P<0.05).Conclusions NAR and MHR levels in END patients are significantly increased.NAR and MHR are risk factors for END after intravenous thrombolysis in AIS patients,and the combined prediction has higher efficacy.