血常规检查中各项参数对急性脑出血患者脑损伤程度及死亡风险预测价值  

The predictive value of parameters in blood routine examination to the degree of brain injury and the risk of death in patients with intracranial hemorrhage

作　　者：史汉童 郭彦谷 侯晓翔 桑贤正 张丹枫 侯立军 SHI Han-tong;GUO Yan-gu;HOU Xiao-xiang;SANG Xian-zheng;ZHANG Dan-feng;HOU Li-jun(Department of Neurosurgery,The Second Affiliated Hospital of the Naval Medical University/Second Military Medical University,Shanghai 200082,China)

机构地区：[1]海军军医大学(第二军医大学)第二附属医院神经外科,上海200082

出　　处：《临床军医杂志》2024年第4期333-337,共5页Clinical Journal of Medical Officers

基　　金：国家自然科学基金(82271396);上海市医学领先专业重点学科基金(21Y21900400)。

摘　　要：目的探讨血常规检查中各项参数对急性脑出血(ICH)患者脑损伤程度及死亡风险的预测价值。方法选取海军军医大学(第二军医大学)第二附属医院自2021年1月至2023年12月收治的80例ICH患者为研究对象。根据格拉斯哥评分(GCS)将患者分为轻度脑损伤组(GCS≥13分,n=49)与中重度脑损伤组(GCS≤12分,n=31)。根据原始脑出血量表评分(OICH)将患者分为低死亡风险组(OICH≤2分,n=64)与高死亡风险组(OICH≥3分,n=16)。收集并比较轻度脑损伤组与中重度脑损伤组、低死亡风险组与高死亡风险组患者的一般资料与实验室检查结果。采用受试者工作特征曲线(ROC)分析血常规检查中各项参数对ICH患者脑损伤程度及死亡风险的预测能力。结果中重度脑损伤组患者冠心病史比例高于轻度脑损伤组,差异有统计学意义(P<0.05)。中重度脑损伤组患者白细胞(WBC)、中性粒细胞(N)、C-反应蛋白(CRP)、单核细胞与淋巴细胞比值(MLR)、中性粒细胞与淋巴细胞比值(NLR)、血小板与淋巴细胞比值(PLR)、系统免疫炎症指数(SII)、全身炎症反应指数(SIRI)均高于轻度脑损伤组,淋巴细胞(L)低于轻度脑损伤组,差异均有统计学意义(P<0.05)。高死亡风险组WBC、N、MLR、NLR、PLR、SII、SIRI均高于低死亡风险组,L低于低死亡风险组,差异均有统计学意义(P<0.05)。ROC曲线结果显示,MLR、PLR、SII、SIRI预测ICH患者脑损伤程度及死亡风险的ROC曲线下面积均低于NLR,差异均有统计学意义(P<0.05)。结论NLR对于预测ICH患者脑损伤程度及死亡风险具有重要价值。Objective To investigate the clinical value of parameters in blood routine examination for patients with intracranial hemorrhage(ICH).Methods A total of 80 ICH patients admitted to The Second Affiliated Hospital of the Naval Medical University/Second Military Medical University from January 2021 to December 2023 were selected as the study objects.Patients were divided into mild brain injury group[glasgow coma scale(GCS)≥13 pionts, n=49]and moderate to severe brain injury group(GCS≤12 pionts, n=31)according to GCS.According to original intracerebral hemorrhage scale(OICH),the patients were divided into a low risk of death group(OICH≤2 pionts, n=64)and a high risk of death group(OICH≥3 pionts, n=16).General data and laboratory results of patients with mild brain injury were collected and compared with those with moderate and severe brain injury, and those with low and high risk of death.Receiver operating characteristic curve(ROC)was used to analyze the ability of parameters in blood routine examination to predict the injury degree and death risk of ICH patients.Results The proportion of coronary heart disease history in moderate to severe brain injury group was higher than that in mild brain injury group, the difference was statistically significant(P<0.05).White blood cell(WBC),neutrophil(N),C-reactive protein(CRP),monocyte to lymphocyte ratio(MLR),neutrophil to lymphocyte ratio(NLR),platelet to lymphocyte ratio(PLR),systemic immuno-inflammatory index(SII)and systemic inflammatory response index(SIRI)were all high in patients with moderate to severe brain injury in mild brain injury group, lymphocyte(L)was lower than that in mild brain injury group, and the differences were statistically significant(P<0.05).WBC,N,MLR,NLR,PLR,SII and SIRI in the high death risk group were higher than those in the low death risk group, and L was lower than those in the low death risk group, with statistical significance(P<0.05).ROC curve results showed that MLR,PLR,SII and SIRI predicted ICH patients with injury degree and

关 键 词：急性脑出血 血常规 中性粒细胞与淋巴细胞比值 脑损伤程度 死亡风险 

分 类 号：R743.34[医药卫生—神经病学与精神病学] R446.11[医药卫生—临床医学]