外周血中性粒细胞与淋巴细胞比值对动脉瘤性蛛网膜下腔出血患者临床结局的预测  

Predictive value of peripheral blood neutrophil-to-lymphocyte ratio in the treatment of aneurysmal subarachnoid hemorrhage

作　　者：张丽丽[1] 胡铭[1] 邹慧敏 冯勋刚[1] 郝延磊[1] ZHANG Lili;HU Ming;ZOU Huimin;FENG Xungang;HAO Yanlei(Affiliated Hospital of Jining Medical University,Jining 272029,China)

机构地区：[1]济宁医学院附属医院,济宁272029

出　　处：《济宁医学院学报》2022年第2期94-97,共4页Journal of Jining Medical University

基　　金：国家自然科学基金项目(81771360);济宁市重点研发计划(软科学项目)(2020JNZC039);济宁市重点研发计划项目(2020JKNS012)。

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)预测动脉瘤性蛛网膜下腔出血(aneurysmal subarachnoid hemorrhage,aSAH)患者的临床结局。方法连续选取2015年1月至2019年12月在济宁医学院附属医院神经内/外科住院的aSAH患者413例。根据患者发病3个月后改良Rankin量表(modified Rankin Scale,mRS)评分情况,分为预后良好组(mRS评分0-2)和预后不良组(mRS评分3-6)。通过单因素及多因素分析影响预后独立因素。结果两组患者性别、年龄、高血压病、糖尿病、冠心病史、吸烟史、饮酒、红细胞计数、血红蛋白、血小板、血钾、血糖、血尿素氮、血肌酐,差异均无统计学意义(P>0.05);两组患者入住ICU、Hunt-Hess分级4-5级者、改良Fisher分级3-4级者、白细胞计数、淋巴细胞百分比、单核细胞百分比、中性粒细胞百分比、淋巴细胞计数、中性粒细胞计数、外周血NLR、血钠、活化部分凝血活酶时间、肺炎、谷丙转氨酶,差异均有统计学意义(P<0.05)。多因素logistic回归分析示,Hunt-Hess分级4-5级者、入住ICU、NLR高是aSAH预后不良的独立危险因素。结论外周血NLR对aSAH患者临床结局有一定预测价值,NLR高可以作为aSAH预后不良的独立危险因素。Objective To explore the predictive value of peripheral blood neutrophil-to-lymphocyte ratio(NLR)in the treatment of aneurysmal subarachnoid hemorrhage(aSAH).Methods This retrospective study included all consecutive 413 aSAH patients admitted to the departments of neurology and neurosurgery in Affiliated Hospital of Jining Medical University over a 5-year period(2015-2019).Functional outcome was assessed 3 months after disease onset with the modified Rankin Scale(mRS)score and categorized into favorable(mRS score 0-2)and unfavorable(mRS score 3-6).Univariate and multivariate analyses were used to investigate factors independently associated with poor outcome.Results No statistically significant differences of sex ratio,age,hypertension,diabetes,coronary heart disease,smoking,drinking,red blood cell count,hemoglobin,blood platelet,serum potassium,blood glucose,blood urea nitrogen or serum creatinine was found between the two groups(P>0.05);Intensive care unit(ICU)admission,patients with 4 to 5 Hunt-Hess grade,patients with 3 to 4 modified Fisher grade,white blood cell count,lymphocyte percentage,monocyte percentage,neutrophil percentage,lymphocyte count,neutrophil count,peripheral blood NLR,serum sodium,activated partial thromboplastin time,pneumonia and alanine transaminase of the two groups were statistically significantly(P<0.05).Multivariate Logistic regression analysis showed that patients with 4 to 5 Hunt-Hess grade,ICU admission and NLR were independent risk factors for poor prognosis of aSAH.Conclusion Peripheral blood NLR is one of risk factors of unfavorable functional outcome in patients with aSAH,and peripheral blood NLR has certain predictive value on unfavorable functional outcome in patients with aSAH.

关 键 词：动脉瘤性蛛网膜下腔出血 中性粒细胞与淋巴细胞比值 预后 

分 类 号：R651.12[医药卫生—外科学]