分析急性脑出血患者早期中性粒细胞/淋巴细胞和CRP与PCT的特点及其临床意义

The characteristics and clinical significance of early neutrophil/lymphocyte,CRP,PCT in patients with acute cerebral hemorrhage were analyzed

目的分析急性脑出血患者早期中性粒细胞/淋巴细胞、CRP、PCT的特点及对患者短期预后的影响。方法回顾性分析本科2018年2月至2020年1月收治的92例急性脑出血患者入院时(T0)、入院第2天(T1)、入院第5天(T2)的中性粒细胞/淋巴细胞(NRL)、CRP、PCT等临床资料。根据出院时的格拉斯哥预后评分(GOS评分)进行分组,分为预后良好组(GOS>3分)和预后不良组(GOS≤3分),分析比较两组在各时间点的中性粒细胞/淋巴细胞(NRL)、CRP、PCT水平。结果T0时,92例患者中性粒细胞、NLR升高,淋巴细胞、CRP、PCT基本正常;T1时,中性粒细胞、NLR、CRP、PCT升高,且中性粒细胞及NLR明显高于T0时(P<0.05);T2时,中性粒细胞、NLR均低于T1时,CRP、PCT均明显高于T1时(P<0.05)。入院时GOS评分低的患者预后不良的发生率更高(P<0.05);Logistic回归分析表明,GOS评分(OR=1.701,95%CI:1.378,2.099)为预测患者短期预后的独立因素。结论急性脑出血患者发病早期出现炎症机制异常,中性粒细胞、NRL变化可在一定程度上反映患者脑水肿发展趋势,但中性粒细胞、NRL、CRP、PCT不影响患者预后;入院时的GOS评分可作为评估急性脑出血患者预后的敏感指标。

Objective To analyze the characteristics of neutrophil/lymphocyte(NRL),CRP,PCT in patients with acute cerebral hemorrhage in the early stage,and their effects on the short-term prognosis of patients.Methods Retrospective analysis was performed on the clinical data of 92 patients with acute cerebral hemorrhage to our department from February 2018 to January 2020,including neutrophils/lymphocytes(NRL),CRP and PCT at admission(T0),day 2(T1)and day 5(T2).According to the Glasgow outcome score(GOS score),the patients were divided into good prognosis group(GOS>3 scores)and poor prognosis group(GOS≤3 scores).The levels of NRL,CRP,PCT were analyzed and compared between the two groups at different time points.Results NLR and APTT increased,lymphocytes CRP and PCT were basically normal at T0 in 92 patients;neutrophils,NLR and CRP increased at T1,neutrophils and NLR increased more significantly than that at T0;neutrophils and NLR decreased at T2,while CRP and PCT increased significantly that compared with T1.The probability of poor prognosis was higher in low GOS score at admission(P<0.05);Logistic regression analysis showed that GOS score(OR=1.701,95%CI:1.378,2.099)was an independent factor of short-term prognosis.Conclusion In the patients with acute cerebral hemorrhage,inflammatory mechanisms were abnormal in the early stage of onset.Changes in neutrophils and NRL can reflect the development trend of patients with cerebral edema to a certain extent.However,neutrophil,NRL,CRP and PCT do not affect the prognosis of patients;GOS score on admission could be used as a sensitive index to predict the prognosis of patients with acute cerebral hemorrhage.