粒细胞/淋巴细胞比率在幕上自发性脑出血诊断中的价值  

The diagnostic value of neutrophil to lymphocyte ratio in spontaneous supratentorial intracerebral hemorrhage

作　　者：姜雅菲 陈志浩[1] 赖华生[1] 林楚曦 郑媚美 陈婷[1] 钟龙辉[1] 陈袆招[2] 何雷[3] 

机构地区：[1]南方医科大学珠江医院神经外科,广州510282 [2]南方医科大学珠江医院神经外科研究所脑功能与再生重点实验室,广州510282 [3]南方医科大学珠江医院内分泌科,广州510282

出　　处：《广东医学》2016年第22期3376-3380,共5页Guangdong Medical Journal

基　　金：国家自然科学基金资助项目(编号:81271314)

摘　　要：目的评估中性粒细胞/淋巴细胞比率(NLR)在幕上自发性脑出血中的临床诊断价值。方法本次研究人群仅限于年龄≥35岁的幕上自发性脑出血患者。研究中采用GOS评分量表量化临床结果,同时根据患者CT扫描情况,使用abc/2方法计算幕上自发性脑出血的出血量。使用logistic回归模型和生存分析来分析独立因素与临床结果的相关性。结果 130例幕上自发性脑出血患者中,30 d内预后效果不良的患者NLR值高于预后效果良好的患者(13.52±14.65 vs 5.82±5.21;P=0.002)。NLR分界值为0.74时,其敏感度为0.611,特异度为0.797。NLR与血肿体积有较强的相关性(r=0.203,P=0.023)。结论 NLR与幕上自发性脑出血患者30 d的GOS评分和出血量呈正相关。Objective To investigate the diagnostic value of Neutrophil -lymphocyte ratio （NLR） in Supratento- rial intracerebral hemorrhage （ICH）. Methods A retrospective study was conducted in consecutive patients ≥35 years old with supratentorial ICH. Clinical outcomes were quantified using GOS grade （ Glasgow Outcome Scale）, while all ad- mission CTs were analyzed regarding ICH volume using the abc/2 - method. The logistic regression model and survival a- nalysis were used to identify factors independently associated with clinical outcomes. Results A total of 130 patients （64. 72 ± 12. 695 years, 80 men and 50 female） with supratentorial ICH were included. NLR in patients with unfavorable outcomes were significantly higher than that in patients with favorable outcomes in 30 days （ 13.52 ± 14. 65 vs. 5.82 ± 5. 21 ; P =0. 002）. A NLR cutoff point of 0. 704 was determined to have a sensitivity of 0. 611 and a specificity of 0. 797. In addition, our study showed that NLR was significantly associated with hematoma volume （ r = 0. 203, P = 0. 023）. Conclusion In this retrospective study, NLR is demonstrated to be positively associated to 30 - days GOS and hemorrhage volume of the supratentorial ICH.

关 键 词：粒细胞/淋巴细胞比率 幕上自发性脑出血 炎症 格拉斯特昏迷量表 血肿体积 

分 类 号：R743.34[医药卫生—神经病学与精神病学]