NLR与PLR及联合指标预测创伤性颅脑损伤预后的临床价值及预后模型的构建  

Clinical value of NLR,PLR and their combined indicators in predicting the prognosis of traumatic brain injury and the construction of prognostic model

作　　者：陈昊阳 冯雷[2] Haoyang Chen;Lei Feng(Department of Critical Medicine,The First Affiliated Hospital of He’nan University of Science and Technology,Luoyang 471000,China;Department of Neurosurgery,Jining First People’s Hospital,Jining 272000,China)

机构地区：[1]河南科技大学第一附属医院重症医学科,洛阳471000 [2]济宁市第一人民医院神经外科,272000

出　　处：《中华神经创伤外科电子杂志》2021年第5期266-270,共5页Chinese Journal Of Neurotraumatic Surgery：Electronic Edition

摘　　要：目的研究创伤性颅脑损伤(TBI)患者生化及炎症指标的变化,探讨外周血中性粒细胞-淋巴细胞比值(NLR)和血小板-淋巴细胞比值(PLR)对患者预后的预测价值。方法回顾性分析济宁市第一人民医院神经外科自2019年1月至2020年1月收治的132例TBI患者的一般资料。根据患者伤后6个月的GOS评分分为预后良好组(91例)和预后不良组(41例)。比较2组患者的NLR和PLR,采用多因素Logistic回归分析影响TBI预后不良的独立危险因素,并构建预后模型,运用受试者工作特征曲线(ROC)分析NLR和PLR单独、联合指标以及各组预后模型对患者预后的预测价值。结果2组患者的NLR、PLR比较差异均有统计学意义(P<0.05)。多因素Logistic回归分析显示年龄、入院GCS评分、NLR以及PLR是TBI患者伤后6个月预后不良的独立危险因素(P<0.05)。根据本研究所得的独立危险因素构建患者预后模型,模型1:年龄+GCS评分;模型2:年龄+GCS评分+NLR;模型3:年龄+GCS评分+PLR;模型4:年龄+GCS评分+NLR+PLR。ROC曲线分析后显示各模型的曲线下面积(AUC)分别为:0.685、0.822、0.671、0.864。其中模型4的AUC最大,表明其预测准确度最高。结论NLR、PLR单独及联合指标对于TBI患者的预后均有一定的预测价值,NLR、PLR值越大,TBI患者6个月预后不良可能性越大,NLR、PLR结合患者年龄和GCS评分共同预测患者预后时准确度显著提升。Objective To study the changes of biochemical and inflammatory indicators in patients with traumatic brain injury(TBI),and to explore the predictive value of peripheral blood neutrophil to lymphocyte ratio(NLR)and platelet to lymphocyte ratio(PLR)on prognosis of patients.Methods The general data of 132 patients with TBI admitted to Neurosurgery Department of Jining First People’s Hospital from January 2019 to January 2020 were analyzed retrospectively.According to the GOS score 6 months after injury,the patients were divided into good prognosis group(91 cases)and poor prognosis group(41 cases).The general clinical data and laboratory examination indicators were collected to analyze whether there were any differences in NLR and PLR between the two groups.Multivariate logistic regression was used to analyze the independent risk factors affecting the poor prognosis of TBI.The prognosis model was constructed,and the predictive value of NLR and PLR alone and combined indicators on the prognosis of patients was obtained by receiver operating characteristic curve(ROC)analysis.Results There were significant differences in NLR and PLR between the two groups(P<0.05).Multivariate regression analysis showed that age,admission GCS score,NLR and PLR were independent risk factors for poor prognosis at 6 months after injury in TBI patients(P<0.05).According to the independent risk factors obtained in this study,the patient prognosis model was constructed.Model 1:age+GCS score;Model 2:age+GCS score+NLR;Model 3:age+GCS score+PLR;Model 4:age+GCS score+NLR.The ROC curve analysis showed that the area under curve(AUC)of each model were 0.685,0.822,0.671 and 0.864 respectively.The AUC of model 4 is the largest,which indicates that the prediction accuracy of model 4 is the highest.Conclusion NLR,PLR and their combined indicators have certain predictive value for the prognosis of TBI patients.The greater the NLR and PLR values,the greater the possibility of poor prognosis in 6 months of TBI patients.The accuracy of NLR,PLR combined wit

关 键 词：创伤性颅脑损伤 中性粒细胞-淋巴细胞比值 血小板-淋巴细胞比值 预后 

分 类 号：R651.15[医药卫生—外科学]