Objective  To explore the value of serum hemoglobin scavenger receptor soluble CD163 (sCD163) combined with neutrophil to lymphocyte ratio (NLR) in predicting the prognosis of patients with stroke-related pneumonia (SAP).

  Methods  The clinical materials of 90 SAP patients from April 2019 to December 2020 were analyzed retrospectively, and they were divided into good prognosis group (n=58) and poor prognosis group (n=32) according to the score of modified Rankin Scale (mRS). The related factors of poor prognosis were analyzed, and correlations between sCD163, NLR and Pneumonia Severity Index (PSI) classification, the National Institutes of Health Stroke Scale (NIHSS) score, Clinical Pulmonary Infection Score (CPIS), the Confusion-Urea-Respiratory Rate-Blood pressure-65 (CURB-65) score, C-reactive protein (CRP) as well as white blood cell (WBC) count were evaluated. Serum sCD163 level and NLR were compared between the two groups, and the values of sCD163 alone, NLR alone and their combination in predicting the poor prognosis of SAP patients were evaluated. Univariate analysis showed that there were significant differences in age, PSI score and classification, NIHSS score, CPIS score, CURB-65 score, CRP and WBC between the poor prognosis group and the good prognosis group (P < 0.001). Binary Logistic regression analysis showed that PSI score and classification of grade Ⅳ to Ⅴ, NIHSS ≥20 scores, CPIS ≥6 scores, CURB-65 ≥3 scores and high expression of CRP and WBC were independent factors for poor prognosis in SAP patients (P < 0.05). The serum sCD163 and NLR in the poor prognosis group were significantly higher than those in the good prognosis group (P < 0.001). Spearman correlation analysis showed that sCD163 and NLR were significantly positively correlated with PSI score, NIHSS score, CPIS score and CURB-65 score (P < 0.05 or P < 0.01). Pearson correlation analysis showed that sCD163 and NLR were significantly positively correlated with CRP and WBC (P < 0.001). The receiver operating characteristic (ROC) curve showed that the area under the curve (AUC) of sCD163 alone, NLR alone and their combination in predicting the poor prognosis of SAP patients were 0.910, 0.867 and 0.915 respectively, and their P values were less than 0.05.

  Conclusion  Serum sCD163 and NLR increase obviously in SAP patients, especially significant in patients with poor prognosis. Combined detection of sCD163 and NLR has a high value in predicting poor prognosis of SAP patients.