炎症指标对创伤性脑损伤后阵发性交感神经亢进的预测价值:单中心回顾性病例对照研究  

Predictive value of inflammatory markers for paroxysmal sympathetic hyperactivity after traumatic brain injury:a single-center retrospective case-control study

作　　者：史汉童 陈文 郭彦谷 桑贤正 张丹枫 侯立军 SHI Hantong;CHEN Wen;GUO Yangu;SANG Xianzheng;ZHANG Danfeng;HOU Lijun(Department of Neurosurgery,The Second Affiliated Hospital of Naval Medical University(Second Military Medical University),Shanghai 200003,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200003

出　　处：《海军军医大学学报》2025年第3期330-335,共6页Academic Journal of Naval Medical University

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：目的探索炎症指标对创伤性脑损伤(TBI)后发生阵发性交感神经亢进(PSH)的预测价值。方法回顾性分析海军军医大学(第二军医大学)第二附属医院2016年12月至2020年11月收治的84例TBI患者的病例资料,根据患者在住院期间是否发生过PSH分为PSH组(n=41)与非PSH组(n=43)。收集并比较两组患者的一般资料和实验室检查结果。采用Kendall相关分析法分析炎症指标与TBI后PSH发生的相关性,采用ROC曲线分析炎症指标对PSH发生的预测价值。结果两组患者的年龄、性别、入院格拉斯哥昏迷量表评分等基线资料差异均无统计学意义(均P>0.05)。与非PSH组患者相比,PSH组患者的白细胞计数、中性粒细胞计数、中性粒细胞/淋巴细胞比值(NLR)、血小板/淋巴细胞比值(PLR)、全身免疫炎症指数(SII)均升高(均P<0.05)。NLR、SII和中性粒细胞计数均与PSH呈正相关(r=0.360、0.308、0.289,均P<0.01),对应ROC的AUC值分别是0.752、0.716和0.702。结论炎症指标NLR、SII及中性粒细胞对TBI后PSH的发生具有预测价值。Objective To explore the value of inflammatory markers in predicting paroxysmal sympathetic hyperactivity(PSH)after traumatic brain injury(TBI).Methods A total of 84 TBI patients who were admitted to The Second Affiliated Hospital of Naval Medical University(Second Military Medical University)from Dec.2016 to Nov.2020 were retrospectively analyzed.They were classified into PSH group(n=41)and non-PSH group(n=43)according to whether PSH occurred during hospitalization.The baseline data and laboratory results of the 2 groups were collected and compared.Kendall correlation analysis was used to analyze the correlation between inflammatory markers and the occurrence of PSH after TBI,and receiver operating characteristic(ROC)curve was used to analyze the predictive value of inflammatory markers to PSH.Results There were no significant differences in baseline data,including age,gender,or Glasgow coma scale score,between the 2 groups(all P>0.05).Compared with patients in the non-PSH group,the neutrophil to lymphocyte ratio(NLR),platelet to lymphocyte ratio(PLR),systemic immune-inflammation index(SII),neutrophils and leukocytes in the PSH group were significantly increased(all P<0.05).NLR,SII and neutrophil were positively correlated with PSH(r=0.360,0.308,0.289;all P<0.01),with the corresponding ROC area under curve values being 0.752,0.716 and 0.702,respectively.Conclusion NLR,SII and neutrophils have a value in predicting the occurrence of PSH after TBI.

关 键 词：创伤性脑损伤 阵发性交感神经亢奋 中性粒细胞 中性粒细胞/淋巴细胞比值 全身免疫炎症指数 

分 类 号：R73[医药卫生—肿瘤]