文章摘要
尚振英 ，牟英峰 ，尹一鸣 ，王丽 ，马爽 ，阚姝 ，耿德勤.中性粒细胞/淋巴细胞比值在自发性脑出血 早期血肿扩大中的预测价值[J].神经损伤功能重建,2019,14(3):120-123
中性粒细胞/淋巴细胞比值在自发性脑出血 早期血肿扩大中的预测价值
The Relationship between Neutrophil/lymphocyte Ratio and Early Hematoma Enlargement inSpontaneous Intracerebral Hemorrhage
  
DOI：
中文关键词: 自发性脑出血  早期血肿扩大  中性粒细胞/淋巴细胞比值
英文关键词: spontaneous intracerebral hemorrhage  early hematoma enlargement  neutrophil/lymphocyte ratio
基金项目:国家卫生健康委中 国脑卒中高危人群 干预适宜技术研究 及 推 广 项 目（No. GN-2018R0009）
作者单位
尚振英1 ，牟英峰2 ，尹一鸣1 ，王丽1 ，马爽1 ，阚姝1 ，耿德勤2 1. 徐州医科大学临 床学院 2. 徐州医科大学附 属医院神经内科 
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中文摘要:
      目的：探讨外周血中性粒细胞/淋巴细胞比值（NLR）在自发性脑出血早期血肿扩大（HE）中的变化及 意义。方法：随机收集198例发病6 h内到达我院并在本院完成首次CT及采血的自发性脑出血患者的临床 资料，根据发病24 h内复查CT分为HE组与无HE组。比较2组发病6 h内（T0）、6~24 h内（T1）NLR及其他 可能影响病情的临床资料。结果：198例脑出血患者，共87例出现HE（HE组），111例未出现HE（无HE组）， 单因素分析显示，2组的性别、饮酒史、入院时收缩压及舒张压水平、格拉斯哥昏迷量表（GCS）评分、血肿体 积、超急性期血肿生长速度（uHG）、NLRT1、入院时血糖、住院期间外科手术率、肺部感染率、院内死亡率的差 异有统计学意义（均P＜0.05），Logistic回归分析显示，NLRT1、GCS评分、uHG是HE的独立相关因素。ROC 曲线分析表明，当 NLRT1截断值为 7.65 时，预测自发性脑出血患者发生 HE 的敏感性为 78.16%，特异性为 81.98%，ROC曲线下面积为0.852（95% CI 0.798~0.907，P=0.00）。结论：自发性脑出血HE患者的NLR明显 升高，发病6~24 h内的NLR可作为HE的预测因子。
英文摘要:
      To investigate the relationship between neutrophil/lymphocyte ratio (NLR) and early hematoma enlargement (HE) in spontaneous intracerebral hemorrhage (ICH). Methods: The clinical data of 198 patients with ICH within 6 hours of onset was collected. All the cases had the first CT scan and blood collection in 6 hours of onset and had the second CT scan 6～24 h of onset. According to the data of CT scan, cases were divided into the early hematoma enlargement (HE) group and the hematoma unexpanded (non-HE) group. The clinical data of NLR within 6 hours (T0), 6-24 hours (T1) and other possible influence factors were compared between the two groups. Results: In 198 ICH cases, 87 had early hematoma enlargement and 111 had no early hematoma enlargement. Univariate analysis showed statistically significant differences in gender, drinking history, systolic blood pressure and diastolic blood pressure at admission, Glasgow Coma Scale (GCS) score, hematoma volume, the speed of ultraearly hematoma growth(uHG), NLRT1, blood glucose at admission, surgical treatment rate, pulmonary infection rate and in-hospital mortality rate between two groups (all P<0.05). Logistic regression analysis showed that NLRT1, GCS score, and uHG were independent correlated factors of HE. ROC curve analysis showed that when the NLRT1 cutoff value was 7.65, the sensitivity of predicting HE in ICH patients was 78.16%, the specificity was 81.98%, and the area under the ROC curve was 0.852 (95%CI: 0.798-0.907, P=0.00). Conclusion: The NLR of ICH patients with HE is significantly elevated, and NLR within 6-24 hours of onset may be a predictor of HE.
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