中性粒细胞和淋巴细胞比率与高血压性脑出血后血肿周围水肿带及患者预后的关系

The Relationship between the Ratio of Neutrophil and Lymphocyte and the Edema Zone Around Hematoma after Hypertensive Cerebral Hemorrhage and the Prognosis of Patients

高血压性脑出血(Hypertensive Intracerebral Hemorrhage, HICH)是患者长期受高血压的影响,使其脑内小动脉内膜层产生粥样硬化斑块、脂肪样变等病理性改变,致使动脉壁抗张力强度和弹性降低向外膨隆形成微动脉瘤导致的脑实质内出血。该病具有高致残率、高病死率的特点,在人类死亡原因中居第二位。造成脑出血转归不良的脑损伤机制,除了血肿造成的机械损伤外,还包括继发性损伤,主要为继发性出血、自由基毒性损伤、炎性反应和继发性脑水肿等。其中,脑水肿作为脑出血后二次损伤发生的关键性因素,对脑组织及神经系统产生严重影响,而且越来越多的研究证实,炎症反应不仅能够加重脑损伤,还能够促进脑水肿的形成。

Hypertensive intracereerebral Hemorrhage（HICH） is a Intracerebral Intracerebral Hemorrhage caused by long-term hypertension, which leads to pathological changes such as atherosclerotic plaques and lipid-like changes in the intima of the Intracerebral artery, resulting in decreased tension strength and elasticity of the arterial wall, which leads to the formation of microaneurysm. The disease has the characteristics of high disability rate and high mortality rate, and is the second leading cause of human death. In addition to the mechanical damage caused by hematoma, the mechanism of brain injury that results in poor prognosis of cerebral hemorrhage also includes secondary injury, mainly including secondary hemorrhage, radical toxicity injury, inflammatory reaction and secondary brain edema. Among them, brain edema, as a key factor of secondary injury after cerebral hemorrhage, has a serious impact on brain tissue and nervous system. More and more studies have confirmed that inflammatory response can not only aggravate brain injury, but also promote the formation of brain edema.