中性粒细胞与淋巴细胞比值联合D-二聚体评估老年高血压脑出血患者预后的价值  

Value of Neutrophil to Lymphocyte Ratio Combined with D-dimer in the Prognosis of Elderly Patients with Hypertensive Cerebral Hemorrhage

作　　者：季学凤 曾凤[1] 朱锐仿 JI Xuefeng;ZENG Feng;ZHU Ruifang(Funing People's Hospital,Funing 224411,China;不详)

机构地区：[1]阜宁县人民医院,江苏阜宁224411

出　　处：《中外医学研究》2024年第5期60-64,共5页CHINESE AND FOREIGN MEDICAL RESEARCH

摘　　要：目的:探究中性粒细胞与淋巴细胞比值(NLR)联合D-二聚体(D-D)评估老年高血压脑出血患者预后的价值。方法:选择2019年1月—2022年11月阜宁县人民医院收治的86例老年高血压脑出血患者作为研究对象,均行微创血肿清除术治疗,收集所有患者的病历资料,检测患者NLR、D-D水平。术后随访28 d,将预后格拉斯预后评分(GOS)评分≤3分作为预后不良组,GOS评分≥4分作为预后良好组。分析老年高血压脑出血患者预后的影响因素,评估NLR、D-D对老年高血压脑出血患者预后的预测效能。结果:术后28 d,86例高血压脑出血患者中,预后良好60例(69.77%),记为预后良好组,余下26例(30.23%)预后不良,记为预后不良组。两组性别、多发伤、高血压病程、舒张压、收缩压、受伤至入院时间、年龄、体重指数(BMI)、乳酸脱氢酶(LDH)水平比较,差异无统计学意义(P>0.05);预后不良组急性生理与慢性健康(APACHEⅡ)评分、血肿量、NLR、D-D水平均高于预后良好组,差异有统计学意义(P<0.05)。logistic分析显示,APACHEⅡ评分、血肿量、NLR、D-D是老年高血压脑出血预后不良的影响因素(P<0.05)。NLR、D-D单一及两者联合预测老年高血压脑出血预后不良的敏感度分别为86.67%、80.00%、93.33%,特异度分别为76.83%、84.15%、90.24%,曲线下面积(AUC)分别为0.868、0.848、0.962。结论:NLR、D-D与老年高血压脑出血患者的预后结局有关,联合可用于预测该患者的预后结局。Objective:To investigate the value of neutrophil to lymphocyte ratio(NLR)combined with D-dimer(D-D)in the prognosis of elderly patients with hypertensive cerebral hemorrhage.Method:A total of 86 elderly patients with hypertensive cerebral hemorrhage who admitted to Funing People's Hospital from January 2019 to November 2022 were selected as the research objects,all patients were treated with minimally invasive hematoma removal,the medical records of all patients were collected and the levels of NLR and D-D were detected.The patients were followed up for 28 d after operation,according to the Glasgow outcome scale(GOS)score,the patients were divided into poor prognosis group(GOS≤3 scores)and good prognosis group(GOS≥4 scores).The influencing factors of prognosis in elderly patients with hypertensive intracerebral hemorrhage were analyzed,and the predictive efficacy of NLR and D-D in elderly hypertensive intracerebral hemorrhage patients was evaluated.Result:At 28 d after operation,among 86 patients with hypertensive cerebral hemorrhage,60 cases(69.77%)had good prognosis,which was recorded as good prognosis group,and the remaining 26 cases(30.23%)had poor prognosis,which was recorded as poor prognosis group.There were no significant differences in gender,multiple trauma,duration of hypertension,diastolic blood pressure,systolic blood pressure,time from injury to admission,age,body mass index(BMI)and lactate dehydrogenase(LDH)between the two groups(P>0.05);the acute physiology and chronic health(APACHEⅡ)score,hematoma volume,NLR and D-D levels in the poor prognosis group were higher than those in the good prognosis group,and the differences were statistically significant(P<0.05).logistic analysis showed that APACHEⅡscore,hematoma volume,NLR and D-D were the influence factors for poor prognosis of hypertensive intracerebral hemorrhage in the elderly(P<0.05).The sensitivity of NLR and D-D alone and combined to predict the poor prognosis of hypertensive intracerebral hemorrhage in elderly patients were 86.67%,80

关 键 词：高血压脑出血 老年 中性粒细胞与淋巴细胞比值 D-二聚体 预后 

分 类 号：R544.1[医药卫生—心血管疾病] R743.34[医药卫生—内科学]