摘要目的:探讨中性粒细胞/淋巴细胞比值（neutrophil/lymphocyte ratio, NLR）以及甘油三酯-葡萄糖（triglyceride-glucose, TyG）指数对非糖尿病急性缺血性卒中（acute ischemic stroke, AIS）患者静脉溶栓后早期神经功能无改善的预测价值。方法:回顾性纳入2023年1月至2023年12月在蚌埠医科大学第一附属医院接受静脉溶栓治疗的非糖尿病AIS患者。收集人口统计学和基线临床资料。早期神经功能改善（early neurological improvement, ENI）定义为静脉溶栓后24 h内美国国立卫生研究院卒中量表（National Institutes of Health Stroke Scale, NIHSS）评分下降≥8分或降至0~1分。应用多变量 logistic回归分析确定AIS患者静脉溶栓后ENI的独立影响因素。采用受试者工作特征（receiver operating characteristic, ROC）曲线评价NLR以及TyG指数对早期神经功能无改善的预测价值。 结果:共纳入122例非糖尿病AIS患者，男性90例（73.8%），年龄（64.43±9.59）岁，37例（30.3%）实现ENI。多变量 logistic回归分析显示，基线NIHSS评分[优势比（odds ratio， OR）1.110，95%置信区间（confidence interval, CI）1.007~1.224； P=0.036]、NLR（ OR 1.199，95% CI 1.001~1.437； P=0.048）以及TyG指数（ OR 2.069，95% CI 1.009~4.244； P=0.047）较高是早期神经功能无改善的独立预测因素。ROC曲线分析显示，NLR预测早期神经功能无改善的曲线下面积为0.682（95% CI 0.581~0.783； P=0.001），最佳截断值为3.44，特异性和敏感性分别为75.7%和57.6%；TyG指数预测早期神经功能无改善的曲线下面积为0.648（95% CI 0.539~0.757； P=0.009），最佳截断值为8.785，特异性和敏感性分别为62.2%和74.1%。 结论:NLR和TyG指数对非糖尿病AIS患者静脉溶栓后早期神经功能无改善具有一定的预测价值。

abstractsObjective:To investigate the predictive value of the neutrophil/lymphocyte ratio (NLR) and triglyceride-glucose (TyG) index for no early neurological improvement (ENI) of non-diabetic patients with acute ischemic stroke (AIS) after intravenous thrombolysis.Methods:Non-diabetic patients with AIS received intravenous thrombolysis in the First Affiliated Hospital of Bengbu Medical University from January 2023 to December 2023 were retrospectively included. Their demographic and baseline clinical data were collected. ENI was defined by a ≥8-point improvement in the National Institutes of Health Stroke Scale (NIHSS) or an NIHSS score of 0 or 1 at 24 hours after intravenous thrombolysis. Multivariate logistic regression analysis was used to determine the independent influencing factors of ENI in patients with AIS after intravenous thrombolysis. The receiver operating characteristic (ROC) curve was used to evaluate the predictive value of NLR and TyG index for no ENI. Results:A total of 122 non-diabetic patients with AIS were enrolled, including 90 males (73.8%), aged 64.43±9.59 years, and 37 (30.3%) patients achieved ENI. Multivariate logistic regression analysis showed that the baseline NIHSS score (odds ratio [ OR] 1.110, 95% confidence interval [ CI] 1.007-1.224; P=0.036), NLR ( OR 1.199, 95% CI 1.001-1.437; P=0.001) and higher TyG index ( OR 2.069, 95% CI 1.009-4.244; P=0.047) were the independent predictors of no ENI. ROC curve analysis showed that the area under the curve of NLR predicting no ENI was 0.682 (95% CI 0.581-0.783; P=0.001). The optimal cutoff value was 3.44, and the specificity and sensitivity were 75.7% and 57.6%, respectively. The area under the curve of TyG index for predicting no ENI was 0.648 (95% CI 0.539-0.757; P=0.009). The optimal cutoff value was 8.785, and the specificity and sensitivity were 62.2% and 74.1%, respectively. Conclusion:NLR and TyG index have certain predictive value for no ENI in non-diabetic patients with AIS after intravenous thrombolysis.