蛛网膜下腔出血患者外周血NLR、LMR、PLR和SII值变化的临床意义

Clinical significance of changes in peripheral blood NLR,LMR,PLR,and SII in patients with subarachnoid hemorrhage

目的 分析动脉瘤性蛛网膜下腔出血(aSAH)对血液学参数的影响及其与患者临床状态和短期预后的关系。方法 分析2019年3月至2022年5月于四川省科学城医院神经外科治疗的62例颅内动脉瘤(IA)破裂急性期患者和55例正常对照组。采用流式细胞术分析两组患者外周血中白细胞(WBC)与淋巴细胞(LC)计数的变化,计算中性粒细胞/淋巴细胞比(NLR)、淋巴细胞/单核细胞比(LMR)、血小板/淋巴细胞比(PLR)和全身免疫-炎症指数(SII),并分析血液学参数与患者临床状况和短期预后的关系。结果 与正常对照组相比,IA破裂组WBC、中性粒细胞(Ns)计数、NLR以及SII均明显升高,而LC计数和LMR降低。此外相比于临床状态恢复良好的患者,临床状态较差的患者LC计数明显降低,而NLR、PLR和SII值明显升高。格拉斯哥昏迷评分法(GCS)评分较低的患者CD3+、CD4-、CD8-细胞比例减少。此外,LC计数降低和PLR升高与较差的短期预后相关。结论 IA破裂后会导致全身免疫和炎症反应,LC计数、NLR、PLR和SII值可以作为临床状态及预后的标志物。

Objective To analyze the impact of aneurysmal subarachnoid hemorrhage(aSAH)on hematological parameters and its relationship with clinical status and short-term prognosis of patients.Methods A total of 62 patients with acute intracranial aneurysm(IA)rupture treated in the Department Neurosurgery of Sichuan Science City Hospital from March 2019 to May 2022 and 55 normal controls were analyzed.Flow cytometry was used to analyze the changes in white blood cell(WBC)and lymphocyte(LC)counts in the peripheral blood of two groups of patients.Neutrophil/lymphocyte ratio(NLR),lymphocyte/monocyte ratio(LMR),platelet/lymphocyte ratio(PLR),and systemic immune inflammatory index(SI I)were calculated,and the relationship between hematological parameters and patient clinical condition and short-term prognosis was analyzed.Results Compared with the normal control group,IA rupture group showed a significant increase in WBC,neutrophil(Ns)count,NLR,and SII,while LC count and LMR decreased.In addition,compared to patients with good clinical recovery,patients with poor clinical status have significantly lower LC counts,while NLR,PLR,and SII values are significantly higher.Patients with lower GCS scores have a reduced proportion of CD3+CD4-CD8 cells.In addition,a decrease in LC count and an increase in PLR are associated with poor short-term prognosis.Conclusion Rupture of IA can lead to systemic immune and inflammatory responses,and LC count,NLR,PLR,and SII values can serve as markers of clinical status and prognosis.