急性脑梗死患者外周血白细胞水平对意识障碍程度的评估价值  

Evaluative value of peripheral blood leukocyte counts on disorders of consciousness in patients with acute cerebral infarction

作　　者：吴冬梅 陆德宾 李玉琴 黄艳玲[3] 胡志安[4] 姚忠祥[4] 张艳[3,5] WU Dongmei;LU Debin;LI Yuqin;HUANG Yanling;HU Zhi’an;YAO Zhongxiang;ZHANG Yan(Department of Neurology,the Second Affiliated Hospital of Chongqing Medical University,Chongqing,400010;Department of Endocrinology,Renji Hospital(the Fifth People's Hospital)of University of Chinese Academy of Sciences,Chongqing,400062;Department of Neurology,Affiliated Central Hospital of Chongqing University(Chongqing Emergency Medical Center),Chongqing,400014;Department of Physiology,College of Basic Medical Sciences,Army Medical University(Third Military Medical University),Chongqing,400038:;Department of Neurology,Qijiang People's Hospital,Chongqing,401420,China)

机构地区：[1]重庆医科大学附属第二医院神经内科,重庆400010 [2]中国科学院大学重庆仁济医院(重庆市第五人民医院)内分泌科,重庆400062 [3]重庆大学附属中心医院(重庆市急救医疗中心)神经内科,重庆400014 [4]陆军军医大学(第三军医大学)基础医学院生理学教研室,重庆400038 [5]重庆市綦江区人民医院神经内科,重庆401420

出　　处：《第三军医大学学报》2021年第16期1575-1580,共6页Journal of Third Military Medical University

基　　金：国家自然科学基金创新研究群体项目(31921003)。

摘　　要：目的探讨急性脑梗死患者外周血白细胞、中性粒细胞、淋巴细胞水平对意识障碍程度的评估价值。方法从2018年1~12月在重庆大学附属中心医院住院的急性脑梗死患者中筛选出136例,按入院时格拉斯哥昏迷指数(Glasgow coma scale,GCS)分为意识障碍组(GCS≤14分,n=59)与无意识障碍组(GCS=15分,n=77),比较两组间外周血白细胞绝对值、中性粒细胞绝对值与百分比、淋巴细胞绝对值与百分比、中性粒细胞/淋巴细胞比值,以及常见血管危险因素(年龄、性别、高血压、糖尿病、房颤、高脂血症)的差异。在意识障碍组中分别比较上述外周血指标与GCS评分的关联性。结果意识障碍组外周血白细胞绝对值、中性粒细胞绝对值和百分比、房颤患者比例均显著高于无意识障碍组,而淋巴细胞绝对值和百分比、中性粒细胞/淋巴细胞比值、年龄、性别以及高血压、糖尿病、高脂血症病史差异均无统计学意义。此外,意识障碍组外周血白细胞绝对值、中性粒细胞绝对值和百分比越高,则GCS评分越低,二者呈负相关。运用协方差分析分别校正了房颤以及其他血管危险因素后,以上负相关仍然存在。结论急性脑梗死患者外周血白细胞、中性粒细胞绝对值和百分比升高与意识障碍GCS评分降低密切相关。Objective To investigate the evaluative values of peripheral blood leukocyte,neutrophil and lymphocyte counts on disorders of consciousness(DOC)in patients with acute cerebral infarction.Methods A total of 136 patients with acute cerebral infarction admitted to the Affiliated Central Hospital of Chongqing University from January to December 2018 were selected in this study.According to Glasgow coma scale(GCS)at admission,they were divided into DOC group(GCS≤14,n=59)and non-DOC group(GCS=15,n=77).The absolute values of peripheral blood leukocyte count and neutrophil count,percentage of neutrophils,absolute value of lymphocytes,percentage of lymphocytes,neutrophil/lymphocyte ratio,and common vascular risk factors(such as age,gender,hypertension,diabetes,atrial fibrillation and hyperlipidemia)were compared between the 2 groups.In addition,the relationships between the above peripheral blood indexes and GCS score were analyzed in the DOC group.Results The absolute values of leukocytes and neutrophils,percentage of neutrophils and proportion of patients with atrial fibrillation were significantly higher in the DOC group than the non-DOC group,but there were no statistical differences in the absolute value of lymphocytes,percentage of lymphocytes,neutrophil/lymphocyte ratio,age,gender,history of hypertension,diabetes and hyperlipidemia between the 2 groups.In addition,the absolute values of leukocytes and neutrophils and percentage of neutrophils in peripheral blood were negatively correlated with GCS scores.The higher the above 3 indexes were,the lower the GCS scores were.After adjustment for atrial fibrillation and other vascular risk factors by analysis of covariance,the above negative correlations still existed.Conclusion The absolute values of peripheral blood leukocytes and neutrophils,and percentage of neutrophils are closely associated with decreased GCS score in acute cerebral infarction patients.

关 键 词：急性脑梗死 意识障碍 外周血 白细胞 中性粒细胞 淋巴细胞 

分 类 号：R446.113[医药卫生—诊断学] R743.3[医药卫生—临床医学]