Clinical significance of changes in GLI and peripheral blood indicators in SAP patients

doi:10.11958/20240531

Abstract

Abstract:

Objective To explore the relationship between glycemic instability index (GLI), peripheral blood CD4⁺/CD8⁺, neutrophil-to-lymphocyte ratio (NLR), red blood cell distribution width (RDW), neutrophil gelatinase-associated lipocalin (NGAL), and the occurrence, condition and prognosis of stroke-associated pneumonia (SAP). Methods According to the occurrence of SAP within 7 d after onset, 550 patients with acute cerebral infarction were divided into the study group (129 cases with SAP) and the control group (421 cases without SAP). GLI, peripheral blood CD4⁺/CD8⁺, NLR, RDW and NGAL levels were measured. The differences in the above indicators were compared between the study group and the control group, as well as SAP patients with different conditions and prognoses. The relationship between above indicators and the occurrence, condition and prognosis of SAP was discussed. The prognostic values of each indicator and combination of indicators were analyzed. Results GLI, NLR, RDW and NGAL levels were higher in the study group, the medium to high risk group and the poor prognosis group than those in the control group, the low-risk group and the good prognosis group. CD4⁺/CD8⁺ was lower than that in the corresponding group (P<0.05). Multivariate Logistic regression analysis showed that higher GLI and NLR were independent risk factors for acute cerebral infarction complicated with SAP, and higher GLI, NLR, RDW and NGAL were independent risk factors for the medium to high risk conditions in SAP patients, while higher levels of CD4⁺/CD8⁺ were protective factor for high-risk diseases in patients with concurrent SAP and SAP (P<0.05). Higher GLI, NLR and RDW were independent risk factors for poor prognosis in patients with SAP (P<0.05). ROC curves indicated that the AUC of the combination of GLI, NLR and RDW for evaluating poor prognosis in patients with SAP was better than that of GLI or RDW. Conclusion Changes in GLI, CD4⁺/CD8⁺ and NLR are influencing factors for the occurrence of SAP. GLI, CD4⁺/CD8⁺, NLR, RDW and NGAL are influencing factors for the severity of SAP patients. GLI, NLR and RDW are associated with poor prognosis in SAP patients, and all three have certain predictive effective in predicting the prognosis of SAP patients, and NLR has the highest predictive efficacy.

Key words: cerebral infarction, prognosis, stroke-associated pneumonia, glycemic instability index, CD4⁺/CD8⁺, neutrophil-to-lymphocyte ratio, red blood cell distribution width, neutrophil gelatinase-associated lipocalin

CLC Number:

R563.1

Figures/Tables 10

References 21

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组别	n		性别（男/女）		年龄/岁		吸烟史		饮酒史
对照组	421		257/164		65.52±8.94		176（41.8）		131（31.1）
研究组	129		71/58		67.02±10.06		63（48.8）		35（27.1）
χ²或t			1.480		1.611		1.987		0.744
组别		基础疾病
组别		高血压		糖尿病		高脂血症		冠心病		房颤
对照组		266（63.2）		89（21.1）		38（9.0）		28（6.7）		46（10.9）
研究组		89（69.0）		36（27.9）		19（14.7）		12（9.3）		22（17.1）
χ²		1.456		2.575		3.457		1.029		3.422

组别	n		性别（男/女）		年龄/岁		吸烟史		饮酒史
对照组	421		257/164		65.52±8.94		176（41.8）		131（31.1）
研究组	129		71/58		67.02±10.06		63（48.8）		35（27.1）
χ²或t			1.480		1.611		1.987		0.744
组别		基础疾病
组别		高血压		糖尿病		高脂血症		冠心病		房颤
对照组		266（63.2）		89（21.1）		38（9.0）		28（6.7）		46（10.9）
研究组		89（69.0）		36（27.9）		19（14.7）		12（9.3）		22（17.1）
χ²		1.456		2.575		3.457		1.029		3.422

组别		n	梗死部位
组别		n	前循环			后循环		前后循环
对照组		421	257（61.0）			112（26.6）		52（12.4）
研究组		129	83（64.3）			25（19.4）		21（16.3）
χ²			3.390
组别	病因分型
组别	SAO			LAA	CE		SOE		SUE
对照组	133（31.6）			131（31.1）	83（19.7）		40（9.5）		34（8.1）
研究组	48（37.2）			36（27.9）	29（22.5）		10（7.8）		6（4.7）
χ²	3.578

组别		n	梗死部位
组别		n	前循环			后循环		前后循环
对照组		421	257（61.0）			112（26.6）		52（12.4）
研究组		129	83（64.3）			25（19.4）		21（16.3）
χ²			3.390
组别	病因分型
组别	SAO			LAA	CE		SOE		SUE
对照组	133（31.6）			131（31.1）	83（19.7）		40（9.5）		34（8.1）
研究组	48（37.2）			36（27.9）	29（22.5）		10（7.8）		6（4.7）
χ²	3.578

组别	n		GLI/[（mmol/L）²/（h·d）]			CD4⁺/CD8⁺
对照组	421		3.38±1.26			1.77±0.48
研究组	129		7.64±2.39			1.27±0.32
t			19.412^＊＊			13.589^＊＊
组别		NLR		RDW/%	NGAL/（μg/L）
对照组		2.45±0.74		12.53±3.42	109.50±21.63
研究组		5.02±1.54		13.96±4.26	126.28±20.63
t		18.374^＊＊		3.480^＊＊	7.791^＊＊