白细胞计数、中性粒细胞/淋巴细胞比值、单核细胞计数对自发性脑出血院内死亡及预后的影响

Effects of white blood cell count,neutrophil/lymphocyte ratio and monocyte count on in-hospital death and prognosis of spontaneous intracerebral hemorrhage

目的:探讨自发性脑出血(sICH)患者院内死亡的危险因素。方法:回顾性分析2015年1月1日至2020年7月31日西南医科大学附属中医医院首诊的154例自发性脑出血患者的临床资料,其中死亡74例,存活80例,将其分为死亡组和生存组,通过单因素和多因素分析探讨影响sICH患者预后的危险因素。结果:单因素分析显示(死亡组vs存活组):白细胞计数(WBC)[11.35(8.69,15.45)vs 7.47(5.94,9.58)]、中性粒细胞/淋巴细胞(NLR)[9.48(6.79,12.96)vs 5.10(3.98,7.13)]、单核细胞计数[0.60(0.48,1.05)vs 0.50(0.37,0.70)],差异有统计学意义(P<0.05);多因素Logistic回归分析结果显示:WBC、NLR、单核细胞计数是影响sICH患者院内死亡的危险因素(P<0.05);ROC曲线分析结果显示:WBC、NLR、单核细胞计数的ROC曲线下面积分别是0.77(95%Cl:0.689-0.847,P<0.001)、0.74(95%Cl:0.663-0.823,P<0.001)、0.62(95%Cl:0.530-0.711,P<0.05)。结论:在sICH患者的诊治过程中,应重视入院时的感染指标,并采取积极措施预防感染,从而更好地改善sICH患者的短期预后。

Objective:To investigate the risk factors of in-hospital death in patients with spontaneous intracerebral hemorrhage(sICH).Methods:a retrospective analysis of 2015 on January 1,2020,to July 31,the southwest Chinese medicine hospital affiliated to medical university first option of the clinical data of 154 patients with spontaneous cerebral hemorrhage,including 74 cases of death,live 80 cases,it can be divided into death and survival groups,by single factor and multiple factors analysis to explore the risk factors affecting the prognosis of patients with sICH.Results:Univariate analysis showed that(death group vs survival group):White blood cell count(WBC)[11.35(8.69,15.45)vs 7.47(5.94,9.58)],neutrophil/lymphocyte count(NLR)[9.48(6.79,12.96)vs 5.10(3.98,7.13)],monocyte count[0.60(0.48,0.48)]1.05vs 0.50(0.37,0.70),the difference was statistically significant(P<0.05);Multivariate Logistic regression analysis showed that WBC,NLR and monocyte count were risk factors for in-hospital death in sICH patients(P<0.05).ROC curve analysis showed that:The area under the ROC curve of WBC,NLR and monocyte count were 0.77(95%Cl:0.689-0.847,respectively).(P<0.001),0.74(95%Cl:0.633-0.823,P<0.001),0.62(95%Cl:0.530-0.711,P<0.05).Conclusion:In the process of diagnosis and treatment of sICH patients,attention should be paid to the indicators of infection at admission,and positive measures should be taken to prevent infection,so as to better improve the short-term prognosis of sICH patients.