中性粒细胞与淋巴细胞比值、氧化应激标志物及计算机体层摄影血管成像-MAAS评分对急性脑梗死患者早期神经功能恶化的预测价值研究OA

Objective:To investigate the relationship between the neutrophil-to-lymphocyte ratio(NLR),oxida-tive stress molecules,computed tomography angiography(CTA)-MAAS score,and early neurological deterioration(END)in patients with acute cerebral infarction(ACI).Methods:A total of 105 patients with ACI treated between January 2023 and December 2025 were enrolled and classified into an END group(n=39)and a non-END group(n=66).Baseline data,admission NLR,oxidative stress markers,and CTA-MAAS scores were compared between groups.Factors related to END and the predictive performance of each index were analyzed.Results:The END group had higher proportions of diabetes and atrial fibrillation and a higher admission NIHSS score than the non-END group(all P＜0.05).NLR and MDA levels were higher,whereas SOD,GSH-Px levels and CTA-MAAS score were lower in the END group(all P＜0.05).After these differential variables were entered into the candidate model and collinearity was assessed,Logistic regression adjusted for diabetes,atrial fibrillation,and admission NIHSS score showed that increased NLR,decreased GSH-Px,and lower CTA-MAAS score were associated with END in patients with ACI(all P＜0.05).The areas under the curve for NLR,GSH-Px,CTA-MAAS score,and their combination in predicting END were 0.724,0.889,0.866 and 0.955,respectively.Conclusion:Elevated NLR,reduced antioxidant capacity(represented by low GSH-Px),and poor collateral circulation(indicated by a low CTA-MAAS score)are independent risk factors for END in ACI patients.The combination of these markers shows good predictive value for END.