NLR值对动脉瘤性蛛网膜下腔出血患者近期预后的评估价值

Value of NLR in the short-term prognosis of patients with aneurysmal subarachnoid hemorrhage

目的探讨影响动脉瘤性蛛网膜下腔出血(aSAH)患者近期预后的相关因素和中性粒细胞/淋巴细胞比值(NLR)对预后的评估价值。方法回顾性分析2016年5月至2018年5月收治的106例aSAH患者的临床资料。根据出院时改良Rankin量表(m RS)评分结果将患者分为预后良好组(n=71)和预后不良组(n=35)。比较两组患者的临床资料,对单因素分析存在差异性的相关指标进行多因素Logistic回归分析,采用受试者工作特征(ROC)曲线对NRL评估aSAH患者近期预后的价值进行分析。结果多因素Logistic回归分析结果显示,Hunt-Hess分级(OR=2. 136)、NLR(OR=1. 257)、血糖(OR=1. 364)、神经系统并发症(OR=3. 251)是aSAH患者近期预后的独立影响因素(P <0. 05,P <0. 01);ROC曲线分析显示,NRL评估aSAH患者近期预后的曲线下面积(AUC)为0. 814(P <0. 01),最佳截断值为10. 92,灵敏度为80. 00%,特异度为71. 82%,约登指数为0. 518。结论 Hunt-Hess分级、NLR、血糖、神经系统并发症是aSAH近期预后的独立影响因素,且NLR对近期预后的评估价值较高。

Objective To investigate the prognostic factors of aneurysmal subarachnoid hemorrhage( aSAH) and the value of neutrophil/lymphocyte ratio( NLR) in the prognosis. Methods The clinical data of 106 patients with aSAH from May 2016 to May 2018 were analyzed retrospectively. According to the results of modified Rankin Scale( m RS) at discharge,the patients were divided into good prognosis group( n = 71) and bad prognosis group( n = 35). The clinical data of the two groups were compared,and the related indexes with differences in single factor analysis were analyzed by multivariate Logistic regression analysis. The value of NLR in evaluating the short-term prognosis of aSAH patients was analyzed by receiver operating characteristic( ROC) curve. Results Multivariate Logistic regression analysis showed that Hunt-Hess grade( OR = 2. 136),NLR( OR = 1. 257),blood glucose( OR = 1. 364) and neurological complications( OR =3. 251) were independent prognostic factors in aSAH patients( P < 0. 05,P < 0. 01). ROC curve showed that area under curve( AUC) of NRL was 0. 814( P < 0. 01),the best cut-off value was 10. 92,sensitivity was 80. 00%,specificity was71. 82%,and Jordan index was 0. 518. Conclusion Hunt-Hess grade,NLR,blood glucose and neurological complications are independent factors affecting the short-term prognosis of aSAH patients,and NLR has a high value in evaluating the short-term prognosis.