创伤性脑出血患者血感染指标与不同周围水肿程度和预后的相关性分析  

Correlation analysis of blood infection index with different degree of peripheral edema and prognosis in patients with traumatic intracerebral hemorrhage

作　　者：张杨 彭紫薇 唐振刚[2] ZHANG Yang;PENG Ziwei;TANG Zhengang(Jinzhou Medical University Shiyan Renmin Hospital Graduate Training Base,Shiyan,Hubei 442000,China;Shiyan Renmin Hospital Affiliated to Hubei University of Medicine,Shiyan,Hubei 442000,China)

机构地区：[1]锦州医科大学十堰市人民医院研究生培养基地,湖北十堰442000 [2]湖北医药学院附属十堰市人民医院,湖北十堰442000

出　　处：《中国医学工程》2023年第5期41-45,共5页China Medical Engineering

摘　　要：目的探讨创伤性脑出血患者血中性粒细胞与淋巴细胞比值(NLR)的变化与不同血肿周围水肿程度和预后的关系。方法选择十堰市人民医院神经外科2019年9月至2022年9月内141例外伤性脑出血患者为病例组,正常组选取同一时间段门诊健康检查者100例,病例组脑出血患者发病后第6 h、24 h、3 d、7 d行头颅CT检查,并通过3D-Slicer软件进行计算血肿周围水肿体积;检测并计算出各时间段患者中性粒细胞与淋巴细胞数值;对照组仅检测NLR值。分析比较轻、中、重度三组不同周围水肿程度在各个时期的NLR;用Spearman法分析NLR水平与周围水肿程度的关系;采用Logistics回归分析NLR水平与脑水肿程度对创伤性脑出血预后的相关性分析。结果病例组NLR数值在各时期均明显高于对照组(P<0.05);病例组NLR数值在6 h至3 d明显升高,3~7 d呈下降趋势(P<0.05)。三组不同程度血肿周围水肿患者的NLR数值在6 h、24 h、3 d之间呈现逐渐增加的趋势,在3 d、7 d内呈现出逐渐降低的趋势,但三组NLR变化趋势并无差别(P>0.05);不同水肿组之间NLR数值比较存在差异(P<0.05),血肿周围水肿程度越高,NLR数值越高;各组在不同时期的NLR均差异有统计学意义(P<0.05)。死亡组的NLR值在6 h、24 h、3 d、7 d均明显高于存活组(P<0.05)。Spearman相关性分析结果显示,随着NLR值的变化,其水肿程度有正性相关性改变。Logistics分析结果显示:创伤性脑出血后中、重度血肿周围水肿和脑出血发病后3 d时的NLR为创伤性脑出血预后的独立危险因素。结论创伤性脑出血患者发病后6 h至3 d内NLR逐渐升高,3~7 d逐渐降低;NLR和血肿周围水肿存在相关性,临床上可利用NLR指标和创伤性脑出血后血肿周围水肿程度对患者预后做判断。【Objective】To investigate the relationship between the changes of neutrophil-to-lymphocyte ratio(NLR)and the degree of perihematoma edema and prognosis in patients with traumatic intracerebral hemorrhage.【Methods】A total of 141 patients with traumatic intracerebral hemorrhage from September 2019 to September 2022 in Department of Neurosurgery,Shiyan Renmin Hospital were selected as the case group,and 100 outpatients in the control group were selected during the same period.The patients in the case group underwent head CT examination at 6 hours,24 hours,3 days and 7 days after onset of intracerebral hemorrhage.The volume of perihematoma edema was calculated by 3D-Slicer software.The numbers of neutrophils and lymphocytes in each time period were detected and calculated.In the control group,only NLR value was detected.The NLR of three groups with different degrees of peripheral edema in each period was analyzed and compared.Spearman's method was used to analyze the relationship between NLR level and the degree of peripheral edema.Logistics regression was used to analyze the correlation between NLR level and the degree of brain edema on the prognosis of traumatic intracerebral hemorrhage.【Results】The NLR value of the case group was significantly higher than that of the control group in each period(P<0.05).The NLR value of the case group increased significantly from 6 hours to 3 days,and decreased from 3 days to 7 days(P<0.05).The NLR values of patients with perihematoma edema of different degrees in the three groups showed a gradual increase trend between 6 hours,24 hours and 3 days,and a gradual decrease trend within 3 days and 7 days,but there was no difference in the change trend of NLR among the three groups.There were significant differences in NLR among different edema groups(P<0.05).The higher the degree of perihematoma edema,the higher the NLR value.There were significant differences in NLR among all groups at different periods(P<0.05).The NLR values of the death group at 6 hours,24 hours,3 days

关 键 词：创伤性脑出血 血肿周围水肿 中性粒细胞-淋巴细胞比值 

分 类 号：R743.34[医药卫生—神经病学与精神病学]