BRAIN评分联合D-二聚体、中性粒细胞/淋巴细胞比值对自发性脑出血血肿扩大的预测价值研究  

Predictive Value Study of BRAIN Score Combined with D-dimer and Neutrophil/lymphocyte Ratio in Hematoma Enlargement of Spontaneous Intracerebral Hemorrhage

作　　者：徐敏[1] 陈云[1] 张力壬 陈凤 耿直[1] XU Min;CHEN Yun;ZHANG Li-ren;CHEN Feng;GENG Zhi(Department of Neurology,The Sixth People's Hospital Affiliated to Shanghai Jiaotong University,Shanghai,200030,China)

机构地区：[1]上海交通大学附属第六人民医院神经内科,上海200030

出　　处：《现代生物医学进展》2022年第1期68-72,共5页Progress in Modern Biomedicine

基　　金：上海市青年科技英才扬帆计划项目(20YF1436400)。

摘　　要：目的:研究BRAIN评分联合D-二聚体、中性粒细胞/淋巴细胞比值(NLR)对自发性脑出血血肿扩大(HE)的预测价值。方法:将我院于2019年4月~2020年6月期间收治的73例自发性脑出血患者纳入研究。将所有受试者按照是否发生HE分作HE组以及无HE组。比较两组各项基线资料以及实验室相关检查指标水平,并通过多因素Logistic回归分析明确自发性脑出血HE的影响因素。此外,采用受试者工作特征(ROC)曲线分析BRAIN评分联合D-二聚体、NLR预测自发性脑出血HE的效能。结果:HE组入院时舒张压以及BRAIN评分、美国国立卫生研究院卒中量表(NIHSS)评分均明显高于无HE组,而格拉斯哥昏迷量表(GCS)评分明显低于无HE组(均P<0.05)。HE组D-二聚体以及NLR水平均高于无HE组(均P<0.05)。经多因素Logistic回归分析发现:D-二聚体、NLR水平以及BRAIN评分均是自发性脑出血HE的危险因素,而GCS评分是其保护因素(均P<0.05)。经ROC曲线分析可得:BRAIN评分联合D-二聚体、NLR预测HE的敏感度、特异度、曲线下面积(AUC)均明显高于各指标单独应用。结论:BRAIN评分联合D-二聚体、NLR对自发性脑出血HE的预测价值较高,具有一定的临床应用价值。Objective: To study the predictive value of BRAIN score combined with D-dimer and neutrophil/lymphocyte ratio(NLR) in hematoma enlargement(HE) of spontaneous cerebral hemorrhage. Methods: A total of 73 patients with spontaneous intracerebral hemorrhage who were admitted to our hospital from April 2019 to June 2020 were included in this study. All subjects were divided into HE group and non-HE group according to whether HE occurred. The baseline data and the level of laboratory examination indexes of the two groups were compared, and Multivariate logistic regression analysis was used to identify the influencing factors of HE of spontaneous cerebral hemorrhage. In addition, receiver operating characteristic(ROC) curve analysis was used to determine the efficacy of BRAIN score combined with D-dimer and NLR in predicting HE of spontaneous intracerebral hemorrhage. Results: The scores of diastolic blood pressure at admission, BRAIN score and National Institutes of Health Stroke Scale(NIHSS) score in HE group were significantly higher than non-HE group, while the Glasgow Coma Scale(GCS) score was significantly lower than that in non-HE group(all P<0.05). The levels of D-dimer and NLR in HE group were higher than those in non-HE group(all P<0.05). Multivariate Logistic regression analysis showed that D-dimer, NLR level and BRAIN score were risk factors for HE in spontaneous intracerebral hemorrhage, while GCS score was a protective factor(all P<0.05). The ROC curve analysis showed that the sensitivity, specificity and area under curve(AUC) of the BRAIN score combined with D-dimer and NLR in predicting HE were significantly higher than those of the single application of each index. Conclusion: BRAIN score combined with D-dimer and NLR has high predictive value on HE in spontaneous intracerebral hemorrhage, which has certain clinical application value.

关 键 词：自发性脑出血 血肿扩大 D-二聚体 中性粒细胞/淋巴细胞比值 BRAIN评分 

分 类 号：R743.34[医药卫生—神经病学与精神病学]