自发性脑出血急性期白细胞计数与近期预后的相关性分析

Relationship between white blood cell counts and short-term outcome in acute phase of spontaneous intracerebral hemorrhage

目的探讨自发性脑出血急性期白细胞计数与近期预后的关系并评价其在近期预后的预测价值。方法收集74例经CT证实的自发性脑出血患者入院时外周血白细胞计数,并应用改良Rankin量表(mRS)对患者第21天神经功能恢复情况进行评分,近期预后差定义为mRS≥4。使用SPSS16.0软件对数据进行统计分析。结果mRS≥4患者36例(48.6%)。mRS≥4组急性期白细胞计数明显高于mRS<4组(P<0.01)。Logistic回归分析显示白细胞计数是近期预后差的一个独立危险因素(OR=1.445,95%CI:1.189～1.755,P<0.01)。白细胞计数的ROC曲线显示曲线下面积为0.803(95%CI:0.698～0.908,P<0.01)。通过ROC曲线分析白细胞计数预测脑出血近期预后差最佳阳性分界值为10.0×109/L。结论自发性脑出血急性期白细胞计数与近期预后密切相关,白细胞计数升高是近期预后的独立危险因素之一,急性期白细胞计数≥10.0×109/L预示近期预后较差。白细胞计数作为近期预后的预测指标价值中等。

Objective To explore the relationship between white blood cell（WBC）counts and short-term outcome in acute phase of spontaneous intracerebral hemorrhage,and assess its predictive value of short-term outcome.Methods A total of 74 patients who had spontaneous intracerebral hemorrhage diagnosed by CT were retrospectively assessed.Records of（WBC） counts in acute phase and modified Rankin Scale（mRS） scores on the 21st day were assessed.Poor outcome was defined as mRS≥4.The results were statistically analyzed by SPSS 16.0.Results Poor outcome occurred in 36 patients.WBC counts was obviously higher in the group of mRS≥4 than in that of mRS4（P0.01）.A Logistic regression model showed that WBC count was an independent danger factor associated with poor outcome（OR=1.445,95%CI：1.189-1.755,P0.01）.ROC curve indicated the area under the curve was 0.803（95%CI：0.698-0.908,P0.01）.The limit value to judge as poor outcome by WBC count was 10.0×109/L through ROC curve analysis.Conclusion Elevated WBC count in acute phase of spontaneous intracerebral hemorrhage is closely associated with poor outcome.WBC count is one of the independent danger factor associated with poor outcome.WBC≥10.0×109/L in acute phase predicts poor outcome in shortterm.The predictive value of WBC count in short-term outcome is passable.