NLR、MHR、CTRP-3及D-二聚体水平对高血压性脑出血患者预后的预测价值  

Prognostic value of NLR,MHR,CTRP-3 and D-dimer levels in patients with hypertensive cerebral hemorrhage

作　　者：丁冬官 陈伟[1] Ding Dongguan;Chen Wei(Department of Neurosurgery,Dongtai People's Hospital,Jiangsu 224200,China)

机构地区：[1]东台市人民医院神经外科,江苏东台224200

出　　处：《齐齐哈尔医学院学报》2025年第7期628-633,共6页Journal of Qiqihar Medical University

摘　　要：目的 分析中性粒细胞与淋巴细胞比率(NLR)、单核细胞与高密度脂蛋白胆固醇比率(MHR)、补体C1q肿瘤坏死因子相关蛋白3(CTRP-3)和D-二聚体(D-D)在高血压性脑出血患者中的表达水平及对患者预后的预测价值。方法 选择2021年12月—2023年12月本院收治的96例高血压脑出血患者(观察组)和79名同期健康体检者(对照组)作为研究对象。比较观察组与对照组血清NLR、MHR、CTRP-3以及D-D水平。96例观察组患者又根据格拉斯预后评分(GOS)分为预后不良组(41例)和预后良好组(55例)两组。分析血清NLR、MHR、CTRP-3以及D-D水平与GOS评分的相关性。Logistic多因素回归分析高血压性脑出血患者预后的影响因素。ROC曲线分析血清NLR、MHR、CTRP-3以及D-D水平预测高血压性脑出血预后的价值。结果 观察组患者血清NLR、MHR以及D-D水平均明显高于对照组,CTRP-3水平明显低于对照组,差异具有统计学意义(P<0.05);GOS评分与CTRP-3水平呈正相关(P<0.05),与NLR、MHR以及D-D水平呈负相关(P<0.05);单因素分析结果显示,血清NLR、MHR、CTRP-3以及D-D水平是患者是否预后不良的影响因素(P<0.05);多因素Logistic回归分析结果显示,患者血清NLR、MHR和D-D水平升高、CTRP-3水平降低均是影响高血压性脑出血患者预后不良的独立危险因素(P<0.05);血清NLR、MHR、CTRP-3和D-D水平预测高血压脑出血患者预后不良的曲线下面积(AUC)分别为0.903、0.950、0.956、0.911,均具有临床预测价值。结论 高NLR、MHR以及D-D,低CTRP-3对判断高血压性脑出血患者的预后不良具有重要意义。Objective To analyze the expression levels of neutrophil to lymphocyte ratio(NLR),monocyte to high-density lipoprotein cholesterol ratio(MHR),complement C1q tumor necrosis factor-associated protein 3(CTRP-3)and D-dimer(D-D)in patients with hypertensive cerebral hemorrhage and their prognostic value.Methods A total of 96 patients with hypertensive cerebral hemorrhage admitted to our Hospital from December 2021 to December 2023 were included as the observation group,and 79 healthy individuals undergoing routine health checkups during the same period were selected as the control group.Serum levels of NLR,MHR,CTRP-3 and D-dimer were compared between two group.Patients in observation group were further divided into poor prognosis group(n=41)and good prognosis group(n=55)according to GOS score.The correlation between serum NLR,MHR,CTRP-3 and D-dimer levels and GOS score was analyzed.Logistic multivariate regression analysis was used to analyze the prognostic factors in patients with hypertensive cerebral hemorrhage.ROC curve analysis of serum NLR,MHR,CTRP-3 and D-dimer levels was used to predict the prognosis of hypertensive cerebral hemorrhage.Results Serum NLR,MHR and D-D levels in the observation group were significantly higher than those in the control group,and CTRP-3 levels were significantly lower than those in the control group(P<0.05).GOS score was positively correlated with CTRP-3 level,and negatively correlated with NLR,MHR and D-D level(P<0.05).Logistic multivariate regression analysis showed that the increase of serum NLR,MHR and D-dimer level and the decrease of CTRP-3 level were independent risk factors affecting the prognosis of patients with hypertensive cerebral hemorrhage(P<0.05).The area under the curve(AUC)of serum NLR,MHR,CTRP-3 and D-D levels in predicting poor prognosis of hypertensive cerebral hemorrhage patients were 0.903,0.950,0.956 and 0.911,respectively,with clinical predictive value.Conclusions High NLR,MHR and D-dimer and low CTRP-3 are of great significance in judging the poor prognosis

关 键 词：高血压性脑出血 中性粒细胞与淋巴细胞比率(NLR) 单核细胞与高密度脂蛋白胆固醇比率(MHR) 补体C1q肿瘤坏死因子相关蛋白3(CTRP-3) D-二聚体(D-D) 预后 

分 类 号：R743.34[医药卫生—神经病学与精神病学]