NLR对动脉瘤性蛛网膜下腔出血后脑积水的预测价值  

Predictive value of neutrophil-to-lymphocyte ratio for hydrocephalus following aneurysmal subarachnoid hemorrhage

作　　者：任祎 佟建洲[1] 孙文栋[1] 张向前[1] 张磊[1] REN Yi;TONG Jianzhou;SUN Wendong;ZHANG Xiangqian;ZHANG Lei(Second Department of Neurosurgery,First Central Hospital of Baoding,Baoding 071000,China)

机构地区：[1]保定市第一中心医院神经外二科,保定071000

出　　处：《临床神经外科杂志》2025年第2期143-148,共6页Journal of Clinical Neurosurgery

基　　金：保定市科技计划项目(2241ZF055)。

摘　　要：目的 探讨中性粒细胞与淋巴细胞计数比值(NLR)对动脉瘤性蛛网膜下腔出血(aSAH)后脑积水的预测价值。方法 回顾性分析2022年1月—2024年11月保定市第一中心医院收治的88例aSAH患者的临床资料,依据头颅CT诊断结果分为脑积水组(27例)和非脑积水组(61例)。收集患者人口学特征、基础疾病史及实验室指标(NLR),采用多因素Logistic回归分析筛选脑积水的独立危险因素,并绘制受试者工作特征(ROC)曲线评估预测效能。结果 脑积水组平均年龄显著高于非脑积水组(分别为67.56±7.29岁和57.41±10.84岁,P<0.001),糖尿病患病率更高(分别为22.2%和4.9%,P=0.022);脑积水组NLR显著高于非脑积水组(分别为15.31±8.84和7.90±5.79,P<0.001)。多因素分析显示,年龄(OR=1.12,95%CI=1.04~1.20,P=0.002)、糖尿病史(OR=6.34,95%CI=1.01~39.78,P=0.049)及NLR(OR=1.21,95%CI=1.09~1.34,P<0.001)为脑积水的独立危险因素。ROC曲线分析表明,NLR的曲线下面积(AUC=0.791)高于年龄(AUC=0.778)和糖尿病(AUC=0.587),三者联合模型的AUC提升至0.874。结论 NLR是aSAH后脑积水的独立预测因子,联合年龄及糖尿病史可显著提高预测效能,为早期识别高危患者提供临床参考。Objective To investigate the predictive value of neutrophil-to-lymphocyte ratio(NLR) for hydrocephalus following aneurysmal subarachnoid hemorrhage(aSAH).Methods The clinical data of 88 aSAH patients admitted from January 2022 and November 2024 were analyzed retrospectively.Patients were categorized into hydrocephalus group(n=27) and non-hydrocephalus(n=61) group based on cranial CT findings.Demographic characteristics,comorbidities,and NLR were analyzed by univariate and multivariate logistic regression.Receiver operating characteristic(ROC) curves were generated to evaluate predictive performance.Results The hydrocephalus group had a significantly higher mean age(67.56±7.29 vs 57.41±10.84 years,P<0.001),NLR(15.31±8.84 vs 7.90±5.79,P<0.001)and diabetes prevalence(22.2% vs 4.9%,P=0.022).Multivariate analysis identified age(OR=1.12,95% CI=1.04-1.20,P=0.002),diabetes(OR=6.34,95% CI=1.01-39.78,P=0.049),and NLR(OR=1.21,95% CI=1.09-1.34,P<0.001) as independent risk factors.ROC analysis revealed that NLR(AUC=0.791) outperformed age(AUC=0.778) and diabetes(AUC=0.587).The combined model achieved an AUC of 0.874.Conclusions NLR is an independent predictor of hydrocephalus after aSAH.Integrating NLR with age and diabetes history enhances predictive accuracy,aiding early clinical intervention.

关 键 词：中性粒细胞与淋巴细胞比值 动脉瘤性蛛网膜下腔出血 脑积水 炎症标志物 预后预测 

分 类 号：R743[医药卫生—神经病学与精神病学]