动脉瘤性蛛网膜下腔出血早期中性粒细胞-白蛋白比值与迟发性脑缺血的相关性研究  

Correlation between Neutrophil to Albumin Ratio and Delayed Cerebral Ischemia in Early Stage of Aneurysmal Subarachnoid Hemorrhage

作　　者：秦东旭 阮金成 侯玉武 高海峰 张功义 QIN Dongxu;RUAN Jincheng;HOU Yuwu(Department of Neurosurgery,989 Hospital of Joint Service Support Force(Pingdingshan District),Pingdingshan City,He’nan Province 467000)

机构地区：[1]联勤保障部队第九八九医院(平顶山院区)神经外科,河南省平顶山市467000

出　　处：《医学理论与实践》2022年第15期2529-2532,共4页The Journal of Medical Theory and Practice

摘　　要：目的:探讨动脉瘤性蛛网膜下腔出血(aSAH)早期中性粒细胞、白蛋白比值(NAR)与迟发性脑缺血(DCI)发生的相关性。方法:采用回顾性病例研究法,选取我院2018年4月—2021年4月68例aSAH患者,入院时进行NAR评估,分析NAR与DCI之间的相关性。结果:有26例患者(38.2%)在aSAH后发生DCI。DCI组平均年龄、具有脑室内出血及糖尿病病史比例、NAR和D-二聚体含量明显高于非DCI组(P<0.05),此外,DCI组和非DCI组在WFNS等级和mFisher等级分类构成方面的差异有统计学意义(P<0.05)。Logistic回归分析,最终纳入方程的变量为NAR、mFisher分级和WFNS等级,OR值分别为3.684、2.496和2.976。NAR、mFisher分级和WFNS分级是动脉瘤性蛛网膜下腔出血并发迟发性脑缺血的主要危险因素。受试者工作特征曲线分析显示,WFNS分级、mFisher分级和NAR的曲线下面积AUC分别为0.721(95%CI:0.657~0.785)、0.763(95%CI:0.700~0.825)和0.812(95%CI:0.763~0.861)。结论:NAR与动脉瘤性蛛网膜下腔出血严重程度呈正相关,NAR可作为动脉瘤性蛛网膜下腔出血后发生迟发性脑缺血的一种新的预测生物标志物。Objective:To investigate the correlation between neutrophil to albumin ratio(NAR)and delayed cerebral ischemia(DCI)in the early stage of aneurysmal subarachnoid hemorrhage(aSAH).Methods:68 patients with aSAH in our hospital from April 2018 to April 2021 were selected by retrospective case study.NAR was evaluated on admission,and the correlation between NAR and DCI was analyzed.Results:DCI occurred in 26 patients(38.2%)after aSAH.The average age,proportion of diabetes history,intraventricular hemorrhage,NAR and D-dimer content in DCI group were significantly higher than those in non DCI group(P<0.05).There were significant differences in WFNS grade and mFisher grade between DCI group and non DCI group(P<0.05).Logistic regression analysis showed that the final variables included in the equation were NAR,mFisher grade and WFNS grade,with OR values of 3.684,2.496 and 2.976,respectively.The AUC of WFNS,mFisher and NAR were 0.721(95%CI:0.657~0.785),0.763(95%CI:0.700~0.825)and 0.812(95%CI:0.763~0.861).Conclusion:NAR is positively correlated with the severity of aneurysmal subarachnoid hemorrhage.NAR can be used as a new biomarker to predict delayed cerebral ischemia after aneurysmal subarachnoid hemorrhage.

关 键 词：动脉瘤性蛛网膜下腔出血 中性粒细胞—白蛋白比值 迟发性脑缺血 预测指标 

分 类 号：R743.35[医药卫生—神经病学与精神病学]