中性粒细胞计数与白蛋白比值与自发性脑出血短期预后的关系  

Relationship Between Neutrophil-albumin Ratio and Short-term Prognosis of Spontaneous Cerebral Hemorrhage

作　　者：王从凯 张鑫 徐瑶[1] 李爱民 WANG Congkai;ZHANG Xin;XU Yao(Department of Neurosurgery,Lianyungang Clinical College of Nanjing Medical University,Jiangsu 222000,China)

机构地区：[1]南京医科大学连云港临床医学院神经外科,222000

出　　处：《医学研究杂志》2023年第11期108-112,共5页Journal of Medical Research

基　　金：江苏省卫生健康委员会科研项目(ZDA2020018)。

摘　　要：目的研究中性粒细胞计数与白蛋白比值(neutrophil-to-albumin ratio,NAR)与自发性脑出血(spontaneous intracerebral hemorrhage,sICH)患者病情严重程度及短期预后的相关性。方法共纳入330例符合入组标准的sICH患者,依据发病30天的改良Rankin量表(modified Rankin scale,mRS)分为预后良好组(mRS≤3分,n=139)和预后不良组(mRS>3分,n=191)。单因素分析两组患者的临床资料,多因素Logistic回归分析明确影响sICH患者预后不良的危险因素。Spearman相关性分析评价NAR与美国国立卫生研究院脑卒中量表(National Institutes of Health Stroke Scale,NIHSS)和脑出血评分之间的相关性。进一步利用受试者操作特征(receiver operating characteristic,ROC)曲线评估NAR对sICH患者早期临床预后的预测价值。结果预后不良组患者的NAR较预后良好组明显增加[0.16(0.13,0.18)vs 0.22(0.19,0.28),P<0.001]。多因素Logistic回归分析结果显示,在调整混杂因素后,NAR是sICH患者预后不良的独立危险因素(OR=1.480,95%CI:1.320~1.521,P<0.001)。NAR与NIHSS评分(r=0.489,P<0.001)及ICH评分(r=0.450,P<0.001)呈中等强度正相关。NAR的ROC曲线下面积为0.818(95%CI:0.771~0.865),显示了较好的预测效能。结论入院时NAR增高与sICH严重程度相关,且是sICH不良预后的独立危险因素。Objective To investigate the relationship between neutrophil-to-albumin ratio(NAR)and severity and prognosis of patients with spontaneous intracerebral hemorrhage(sICH).Methods A total of 330 patients with sICH who met the enrollment criteria were included.They were divided into good prognosis group(mRS≤3,n=139)and poor prognosis group(mRS>3,n=191)according to the modified Rankin scale at 30days after onset.The clinical data of the two groups were analyzed by Univariate analysis,and the risk factors affecting the poor prognosis of sICH patients wereidentified by multivariate Logistic regression analysis.Spearman correlation analysis was used to explore the correlations between NAR and National Institute of Health stroke scale and intracerebral hemorrhage scale.The receiver operating characteristic(ROC)curve was further used to evaluate the predictive value of NAR in the early clinical prognosis of sICH patients.Results The NAR of patients with poor prognosis was significantly higher than that of patients with good prognosis[0.16(0.13,0.18)vs 0.22(0.19,0.28),P<0.001].Multivariate Logistic regression analysis showed that NAR was an independent risk factor for poor prognosis in patients with sICH after adjusting for confounding factors(OR=1.480,95%CI:1.320-1.521,P<0.001).NAR was moderately positively correlated with NIHSS(r=0.489,P<0.001)and ICH score(r=0.450,P<0.001).The area under the ROC curve of NAR was 0.818(95%CI:0.771-0.865),indicating good prediction efficiency.Conclusion Elevated NAR on admission was associated with the severity of sICH,and NAR represents an independent factor associated with poor outcome in sICH patients.

关 键 词：中性粒细胞-白蛋白比值 自发性脑出血 生物学标志物 预后 

分 类 号：R743.34[医药卫生—神经病学与精神病学]