摘要
目的探讨中性粒细胞/淋巴细胞比值(NLR)与老年高血压性脑出血(HICH)患者治疗后脑水肿程度的相关性,以及NLR预测患者短期预后的临床价值。方法选取2018年1月至2021年12月113例老年HICH患者,通过改良Rankin量表(mRS)进行治疗后转归情况评定,依据mRS评分中位数将患者分为预后不良及良好组。采用Spearman相关分析检验mRS评分与各临床实验室指标及早期脑水肿严重程度间的相关性。为进一步确定对患者预后及死亡情况产生影响的相关临床预测指标,采用多因素logistic回归分析法评估预后的危险因素。结果与预后良好组相比,预后不良组患者中具有糖尿病病史及中重度脑水肿患者比例较高(P<0.05),白细胞(WBC)计数及淋巴细胞(LY)计数下降,而NLR水平和出血量上升(P<0.05)。糖尿病史、LY计数、NLR及脑水肿程度是影响患者短期预后的危险因素。联合NLR指标、糖尿病史、LY计数以及脑水肿程度构建的模型可有效预测老年HICH患者短期预后情况(曲线下面积为0.868)。NLR与患者继发脑水肿的程度存在正相关性。结论老年HICH患者继发脑水肿的程度及短期预后与NLR等临床预测指标密切相关,这为此类患者的个体化治疗及脑水肿早期预防提供了一定理论依据。
Objective To investigate the correlation between neutrophil/lymphocyte ratio(NLR)and the degree of encephaledema in elderly patients with hypertensive intracerebral hemorrhage(HICH),and the clinical value of NLR in predicting short⁃term prognosis.Methods From January 2018 to December 2021,113 elderly HICH patients were evaluated by modified Rankin scale(mRS).According to the median mRS score,the patients were divided into poor prognosis group and good prognosis group.Spearman correlation analysis was used to test the correlation between mRS score and clinical laboratory indexes and the severity of early encephaledema.Multivariate logistic regression analysis was used to assess risk factors of prognosis.Results Compared with the good prognosis group,the poor prognosis group had higher proportion of patients with a history of diabetes mellitus and moderate/severe encephaledema,lower levels of white blood cell(WBC)and lymphocyte(LY),higher NLR level and more bleeding volume(P<0.05).The history of diabetes,LY count,NLR and the degree of encephaledema were independent factors affecting the short⁃term prognosis of patients.The model combining NLR,diabetes mellitus history and encephaledema could effectively predict the short⁃term prognosis of elderly HICH patients(area under curve value 0.868).There was a significant positive correlation between NLR and the degree of secondary encephaledema.Conclusion The degree of secondary encephaledema and short⁃term prognosis of elderly HICH patients are closely related to clinical predictors such as NLR,which provides a theoretical basis for individualized treatment and early prevention of encephaledema in these patients.
作者
张寒
李军
刘小江
管义祥
Zhang Han;Li Jun;Liu Xiaojiang;Guan Yixiang(Department of Neurosurgery,Hai an People’s Hospital,Hai an 226600,China)
出处
《海军医学杂志》
2024年第11期1153-1157,共5页
Journal of Navy Medicine
基金
江苏省卫生健康委员会科研项目(Z2019033)。
关键词
中性粒细胞/淋巴细胞比值
老年
脑出血
脑水肿
预后
Neutrophil/lymphocyte ratio
Elderly
Cerebral hemorrhage
Encephaledema
Prognosis
