血清白蛋白及中性粒细胞/淋巴细胞比值预测创伤性脑出血患者预后的价值

Prognostic value of serum albumin and neutrophil/lymphocyte ratio in patients with traumatic cerebral hemorrhage

目的探讨血清白蛋白(Alb)及中性粒细胞/淋巴细胞比值(NLR)预测创伤性脑出血(TICH)患者预后的价值。方法选取海南省第三人民医院收治的TICH患者240例,根据28d预后情况分为存活组(n=187)和死亡组(n=53),检测入院第1、3、5天血清Alb及NLR水平变化。应用受试者工作特征(ROC)曲线,分析各时间点血清Alb及NLR预测TICH患者预后的价值。结果死亡组第1、3、5天血清Alb(g/L)水平均明显低于存活组(32.75±5.62vs.39.35±6.28,29.30±4.58vs.43.46±7.52,22.37±4.20vs.45.42±7.64,均P<0.05),而死亡组第1、3、5天NLR均明显高于存活组(6.03±2.35vs.4.36±1.34,7.14±2.38vs.3.36±1.25,8.50士3.25vs.2.14±0.92,均P<0.05)。ROC曲线显示,第3天血清Alb及NLR水平预测TICH患者预后的最佳界值分别为31.40、5.24,第3天两项联合预测TICH患者预后的AUC(95%Cl)为0.924(0.860~0.973),明显高于单项Alb[0.834(0.781~0.892)]及NLR的AUC[0.850(0.780~0.897)],其敏感度和特异度分别为92.6%和87.3%。结论血清Alb及NLR水平变化与TICH患者的病情相关,第3天两项联合检测对TICH患者预后的预测价值较高。

Objective To explore the prognostic value of serum albumin(Alb)and neutrophil/lymphocyte ratio(NLR)in patients with traumatic cerebral hemorrhage(TICH).Methods A total of 240 patients with TICH admitted to Hainan Third People's Hospital were divided into survival group(n=187)and death group(n=53)according to the prognosis of 28 days.Alb and NLR levels were measured on the first,third and fifth days after admission.The ROC curve was used to analyze the predictive value of Alb and NLR at different time points for the death of TICH patients.Results Serum Alb levels in the death group on the first,third and fifth days were significantly lower than those in the survival group[(32.75±5.62)g/Lvs.(39.35±6.28)g/L,(29.30±4.58)g/Lvs.(43.46±7.52)g/L,(22.37±4.20)g/L vs.(45.42±7.64)g/L,all were P<0.05):NLR in the death group was significantly higher than that in the survival group on the first,third and fifth days[(6.03士2.35)vs.(4.36±1.34),(7.14±2.38)vs.(3.36±1.25),(8.50±3.25)vs.(2.14±0.92),all were P<0.05).The ROC curve showed that the optimal threshold values of serum Alb and NLR levels on the third day for predicting death in TICH patients were 31.40 g/L and 5.24,respectively.The AUC(95%CI)of the two combined[0.924(0.860-0.973)]prediction of TICH death on the third day was significantly higher than that of single Alb[0.834(0.781-0.892)]or NLR[0.850(0.780-0.897)],with the sensitivity and specificity of 92.6%and 87.3%,respectively.Conclusion Alb and NLR levels were correlated with the condition of TICH patients,and the combination of the two items on the third day has a higher value in predicting the prognosis of TICH patients.