中性粒细胞/淋巴细胞比值与脑出血早期功能恶化的关系

Investigation of relationship between NLR and neurological deterioration in patients with intracerebral hemorrhage

目的探究急性脑出血患者发病24小时内中性粒细胞/淋巴细胞比值(NLR)的变化及意义,分析NLR与急性脑出血早期功能恶化的关系。方法连续收集2016年1月至2017年8月就诊于安徽医科大学附属省立医院神经内科的脑出血患者157例,分为恶化组和非恶化组,分析入院时白细胞计数、中性粒细胞绝对值、淋巴细胞绝对值、NLR等指标,评估NLR对急性脑出血早期神经功能恶化的预测价值。结果 157例急性脑出血患者中,恶化组45例,未恶化组112组。恶化组白细胞计数(11.11±4.53)×10~9/L、中性粒细胞百分比(82.04±10.77)%、中性粒细胞绝对值(9.47±4.41)×10~9/L及NLR中位数均较未恶化组高,差异均有统计学意义(P<0.05);恶化组入院时血肿体积中位数、美国国立卫生院神经功能缺损评分(11.68±5.45)分、破入脑室比例(37.8%)较非恶化组高,差异均有统计学意义(P<0.05);恶化组淋巴细胞百分比(12.14±7.91)%,较未恶化组降低,差异有统计学意义(P<0.05)。进一步行二分项logistic回归分析,入院时中性粒细胞百分比、中性粒细胞绝对值、NHISS评分及出血破入脑室为脑出血早期神经功能恶化的危险因素,NLR不是危险因素。结论入院时NLR不是脑出血患者早期神经功能恶化的危险因素。

Objective To explore the changes of neutrophil/lymphocyte ratio(NLR)and its significance in acute intracerebral hemorrhage within 24 hours,and to evaluate the relationship between early functional deterioration and NLR.Methods A total of 157 cases of patients with intracerebral hemorrhage were recruited from the Department of Neurology in our hospital from January 2016 to August 2017.We analyzed white blood cells count(WBC),absolute neutrophil count(ANC),the absolute lymphocyte count(ALC),neutrophil/lymphocyte ratio(NLR)and other indicators for the evaluation of whether NLR was predictive for early neurological deterioration.Results There were 157 cases with acute cerebral hemorrhage,among whom 45 cases with deterioration were divided into ND group,and 112 cases without deterioration were categorized as non-ND group.White blood cell count(11.11±4.53)×10 9/L,neutrophil percentage(82.04±10.77)%,absolute neutrophil count(9.47±4.41)×10 9/L and the median of NLR in ND group were more higher than non-ND group,and the difference was statistically significant(P<0.05).The hematoma volume,NIHSS score(11.68±5.45)and the percentage of broking into ventricle in ND group significantly increased,and the difference was statistically significant(P<0.05).Compared to non-ND group,the lymphocyte percentage in ND group decreased,and the difference was statistically significant(P<0.05).By logistic regression analysis,admission neutrophil percentage,absolute neutrophil count,NHISS score and whether breaking into the ventricle were independent risk factors for early neurological deterioration in cerebral hemorrhage,and NLR was not an independent risk factor.Conclusion NLR may not be the risk factor related to early neurological deterioration in patients with acute cerebral hemorrhage.