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  • 马炜,牛紫光,孙毓锴,李建翠,孙婷婷,岳展伊,高谦.中性粒细胞与淋巴细胞比值在颅内出血患者预后判断中的临床价值[J].第二军医大学学报,2018,39(11):1219-1223    [点击复制]
  • MA Wei,NIU Zi-guang,SUN Yu-kai,LI Jian-cui,SUN Ting-ting,YUE Zhan-yi,GAO Qian.Predictive value of neutrophil-to-lymphocyte ratio for prognosis of patients with intracerebral hemorrhage[J].Acad J Sec Mil Med Univ,2018,39(11):1219-1223   [点击复制]
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中性粒细胞与淋巴细胞比值在颅内出血患者预后判断中的临床价值
马炜1△,牛紫光2△,孙毓锴1,李建翠3,孙婷婷1,岳展伊1,高谦1*
0
(1. 海军军医大学(第二军医大学)长海医院实验诊断科, 上海 200433;
2. 上海交通大学附属第一人民医院检验科, 上海 200080;
3. 莱芜市钢城区黄庄中心卫生院, 莱芜 271127
共同第一作者
*通信作者)
摘要:
目的 探讨中性粒细胞与淋巴细胞比值(NLR)对颅内出血患者预后判断的临床价值。方法 选择2013年1月至2014年8月在海军军医大学(第二军医大学)长海医院住院治疗的患者226例,其中首次颅内出血患者126例、高血压患者100例(对照)。分析颅内出血患者和高血压患者的白细胞(WBC)、中性粒细胞、淋巴细胞计数并计算NLR。采用受试者工作特征(ROC)曲线评估颅内出血预后的判断指标,运用多因素logistic回归模型分析颅内出血的预后影响因素。结果 颅内出血患者的WBC计数和NLR高于高血压患者(P均<0.01)。与改良Rankin量表(mRS)评分为0~2分的颅内出血患者(94例)相比,mRS评分为3~6分颅内出血患者(32例)的WBC计数(P<0.05)、中性粒细胞计数(P<0.01)和NLR(P<0.01)更高。大体积血肿(≥30 mL)颅内出血患者(42例)中性粒细胞计数和NLR高于小体积血肿(<30 mL)患者(84例,P均<0.05)。ROC曲线评估结果显示,NLR的临界值为3.001时,预测颅内出血预后的灵敏度为64.5%,特异度为83.3%。多因素logistic回归模型分析显示NLR是颅内出血预后的独立预测因子。结论 NLR可能是预测作为颅内出血预后的有价值的生物标志物。
关键词:  中性粒细胞与淋巴细胞比值  颅内出血  生物学标记  预后
DOI:10.16781/j.0258-879x.2018.11.1219
投稿时间:2018-05-28修订日期:2018-08-02
基金项目:长海医院青年启动基金(CH201706).
Predictive value of neutrophil-to-lymphocyte ratio for prognosis of patients with intracerebral hemorrhage
MA Wei1△,NIU Zi-guang2△,SUN Yu-kai1,LI Jian-cui3,SUN Ting-ting1,YUE Zhan-yi1,GAO Qian1*
(1. Department of Laboratory Medicine, Changhai Hospital, Navy Medical University(Second Military Medical University), Shanghai 200433, China;
2. Department of Laboratory Medicine, Shanghai General Hospital, Shanghai Jiao Tong University, Shanghai 200080, China;
3. Huangzhuang Health Center, Gangcheng District, Laiwu 271127, Shandong, China
Co-first authors.
* Corresponding author)
Abstract:
Objective To explore the clinical value of neutrophil-to-lymphocyte ratio (NLR) in predicting prognosis of the patients with intracerebral hemorrhage (ICH). Methods A total of 226 patients who admitted to Changhai Hospital of Navy Medical University (Second Military Medical University) from Jan. 2013 to Aug. 2014 were enrolled in this study, including 126 patients with first-ever ICH and 100 patients with hypertension (control). The counts of white blood cell (WBC), neutrophil, and lymphocyte were analyzed, and NLR value was calculated. The receiver operating characteristic (ROC) curve was used to evaluate the prognostic indicators of ICH, and the multivariate logistic regression model was used to analyze the influencing factors for the prognosis of the ICH patients. Results The WBC count and NLR value were significantly greater in the ICH patients than those in the hypertension patients (both P<0.01). The ICH patients with modified Rankin scale (mRS) score of 3-6 (n=32) had significantly greater counts of WBC and neutrophil, and NLR value versus those with mRS score of 0-2 (n=94, all P<0.05). And the ICH patients with large hematoma (hematoma volume ≥ 30 mL, n=42) had significantly greater neutrophil count and NLR value versus those with small hematoma (<30 mL, n=84; both P<0.05). When 3.001 was accepted as a cut-off value for NLR predicting prognosis, the sensitivity and the specificity were 64.5% and 83.3%, respectively. Multivariate logistic regression analysis revealed that NLR was an independent predictor for ICH prognosis. Conclusion NLR may be used as an indicator to evaluate the prognosis of ICH.
Key words:  neutrophil-to-lymphocyte ratio  intracerebral hemorrhage  biological markers  prognosis