脑出血患者外周血中性粒细胞/淋巴细胞和血小板/淋巴细胞比值的临床意义

Clinical significance of neutrophils/lymphocyte and platelet/lymphocyte ratio of peripheral blood in patients with intracerebral hemorrhage

摘要:

目的  研究自发性脑出血（ICH）患者外周血中性粒细胞/淋巴细胞比值（NLR）和血小板/淋巴细胞比值（PLR）的临床意义。方法  随机选取自发性脑出血患者363例及健康体检者95例归为脑出血组及对照组。比较两组及不同神经功能缺损程度患者的NLR、PLR，计算受试者工作曲线（ROC），用曲线下面积评价各指标的诊断价值。发病90d时进行随访，比较生存组及死亡组的NLR、PLR。结果  ICH组的NLR、PLR高于健康对照组，差异有统计学意义（P <0.05）；高血压脑出血组与非高血压脑出血组的NLR、PLR比较差异均无统计学意义（P >0.05）；NLR、PLR的ROC曲线下面积分别为0.887和0.635；NLR、PLR在轻度神经功能缺损组与中度神经功能缺损组间比较差异无统计学意义（P >0.05）；而NLR、PLR在重度神经功能缺损组与中度组及轻度组间比较差异有统计学意义（P <0.05）；生存患者与死亡患者的NLR比较，差异无统计学意义（P >0.05）；生存患者与死亡患者的PLR比较，差异有统计学意义（P <0.05）；以ROC曲线的临界值分组，与PLR<157组的患者相比，PLR>157组患者的神经功能预后更差（P <0.05）。结论  脑出血患者的NLR、PLR均升高，NLR的诊断价值高于PLR，NLR可能与患者急性期神经功能缺损程度相关，PLR可能与患者的90d神经功能预后相关。

关键词:

脑出血;中性粒细胞/淋巴细胞比值;血小板/淋巴细胞;神经功能缺损程度;预后

Abstract:

Objective To study the clinical significance of neutrophils/lymphocyte and platelet/lymphocyte ratio of peripheral blood in patients with intracerebral hemorrhage. Methods 363 patients with spontaneous cerebral hemorrhage and 95 cases of physical examination were randomly selected as cerebral hemorrhage group and the control group. The NLR, PLR in two groups and in patients with different degree of nerve function defect were compared. Subjects working curves (ROC) was calculated, and the area under curve was used to evaluate the diagnostic value of every index. NLR, PLR in survival group and death group were compared after the follow-up of 90 days' onset. Results Both the NLR, PLR were significantly higher in patients with cerebral hemorrhage than in control group, the difference was statistically significant (P < 0.05). The NLR and PLR level had no  statistically difference in hypertension cerebral hemorrhage group and non-hypertension cerebral hemorrhage group (P > 0.05). The area under the ROC curve of NLR and PLR were 0.887 and 0.635. There was no statistical difference of NLR and PLR in mild neurologic function defect group and moderate group (P > 0.05). The levels of NLR and PLR were significantly higher with statistically significant in severe neurologic function defect group and moderate or mild group (P < 0.05). NLR had no statistically significant difference between survival patients and death patients (P > 0.05), while a statistically significant difference was found in PLR between two groups (P < 0.05). When patients divided into two groups on the basis of a PLR level cut-off value of 157 based on receiver operating characteristic (ROC) curve, the patients with high-PLR values had worse functional outcomes (mRS > 3) compared with the patients with low-PLR values (P = 0.002, at third month). Conclusions Both the NLR, PLR are significantly higher in patients with cerebral hemorrhage than in control group. The diagnostic value of NLR is higher than the PLR. NLR may be associated with patients in the degree of acute nerve function defect, while PLR may be associated with the prognosis of nerve function.

Key words:

cerebral hemorrhage; neutrophils/lymphocyte ratio; platelet/lymphocytes; degree of nerve function defect; prognosis