摘要
目的探讨外周血中性粒细胞与淋巴细胞比值（neutrophil to lymphocyte ratio, NLR）对急性脑出血患者转归的预测价值。方法连续纳入经头颅CT确诊为脑出血的住院患者。采用改良Rankin量表（modified Rankin Scale, mRS）评估90 d时功能转归，0～2分定义为转归良好，3～6分定义为转归不良，6分为死亡。单变量分析比较组间人口统计学特征、基线资料、影像学和实验室检查结果。应用多变量logistic回归分析确定NLR与转归的独立相关性，受试者工作特征（receiver operating characteristic, ROC）曲线分析评价NLR对转归的预测价值。结果共纳入205例急性脑出血患者，其中107例（52.2%）转归不良，57例（27.8%）死亡。转归不良组患者年龄（P＝0.038）、格拉斯哥昏迷量表（Glasgow Coma Scale, GCS）评分（P＝0.001）、美国国立卫生研究院卒中量表（National Institutes of Health Stroke Scale, NIHSS）评分（P＝0.001）、中性粒细胞计数（P＝0.015）、淋巴细胞计数（P＝0.002）、NLR（P＝0.001）、空腹血糖（P＝0.012）、超敏C反应蛋白（P＝0.002）、血肿体积（P＝0.005）以及血肿破入脑室的患者比例（P＝0.004）与转归良好组差异均有统计学意义。死亡组患者年龄（P＝0.002）、既往卒中史（P＝0.018）、GCS评分（P＝0.001）、NIHSS评分（P＝0.001）、中性粒细胞计数（P＝0.008）、淋巴细胞计数（P＝0.001）、NLR（P＝0.001）、空腹血糖（P＝0.016）、血肿体积（P＝0.001）以及血肿破入脑室的患者比例（P＝0.002）与生存组差异均有统计学意义。多变量logistic回归分析显示，校正混杂因素后NLR是转归不良[优势比（odds ratio, OR）2.405，95%可信区间（confidence interval, CI）1.613～3.587；P＝0.001]和死亡（OR 2.268，95% CI 1.532～3.358；P＝0.001）的独立预测因素。ROC曲线分析表明，NLR对90 d时转归不良有较高的预测价值（ROC曲线下面积0.703�
Objective To investigate the predictive value of neutrophil to lymphocyte ratio （NLR） in peripheral blood for the outcomes in patients with acute intracerebral hemorrhage. Methods Consecutive inpatients with intracerebral hemorrhage diagnosed with the head CT were enrolled. The modified Rankin Scale （mRS） was used to evaluate the functional outcomes at 90 d, 0-2 was defined as good outcome, 3-6 were defined as poor outcome, and 6 was defined as death. Univarlate analysis was used to compare the demographic characteristics, baseline data, imaging, and laboratory findings between the groups. Multivariate logistic regression analysis was used to determine the independent correlation between NLR and the outcomes, and receiver operating characteristics （ROC） analysis was performed to assess the predictive value of NLR for the outcomes. Results A total of 205 patients with acute intracerebral hemorrhage were enrolled in the study, 107 （52. 2%） had poor outcome and 57 （27. 8%） died. There were significant differences in age （P = 0. 038）, Glasgow Coma Scale （GCS） scores （P = 0. 001）, National Institutes of Health Stroke Scale （NIHSS） scores （P = 0. 001）, neutrophil count （P = 0. 005）, lymphocyte count （P = 0. 002）, NLR （P= 0. 001）, fasting blood glucose （P= 0. 012）, hypersensitivity C-reactive protein （P = 0. 002）, hematoma volume （P =0. 005）, and proportion of bleeding into the ventricles （P = 0. 002） between the poor outcome group and the good outcome group. There were significant differences in age （P = 0. 002）, previous stroke （P =0. 018）, GCS scores （P =0. 001）, NIHSS scores （P =0. 001）, neutrophil count （P=0.008）, lymphocyte count （P= 0.001）, NLR （P= 0.001）, fasting blood glucose （P= 0.016）, hematoma volume （P= 0. 001）, and proportion of bleeding into ventricle （P= 0. 002） between the death group and the survival group. Multivariate logistic regression analysis showed that NLR was an independent predictive fa
作者
张芸
樊新颖
张顺源
罗倩
王晋秋
蒲明军
左家财
李肇坤
段劲峰
Zhang Yun Fan Xinying Zhang Shunyuan Luo Qian Wang Jinqiu Pu Mingjun Zuo Jiacai Li Zhaokun Duan Jinfeng(Department of Neurology, Mianyang Central Hospital, Mianyang 621000, China Department of Neurology, Jinling Hospital, Nanjing University School of Medicine, Nanjing 210002, China Department of Radiology, Mianyang Central Hospital, Mianyang 621000, Chin)
出处
《国际脑血管病杂志》
2017年第7期638-643,共6页
International Journal of Cerebrovascular Diseases
关键词
脑出血
白细胞计数
中性粒细胞
淋巴细胞
预后
Cerebral Hemorrhage
Leukocyte Count
Neutrophils
Lymphocytes
Prognosis
