Department of Neurosurgery, The First Affiliated Hospital of Fujian Medical University, Fuzhou, China.
Department of Critical Care, The First Hospital of Fuzhou, Fuzhou, China.
Sci Rep. 2018 Apr 11;8(1):5799. doi: 10.1038/s41598-018-23934-x.
It is not fully established whether leukocyte can predict the poor outcome for ruptured cerebral aneurysms (CA) or not. Here, we retrospectively analyzed the clinical data of 428 patients with ruptured CA between 2010 and 2015. Patients' demographic data, including gender, age, history of smoking, alcohol, hypertension, diabetes and hypercholesterolemia, Hunt-Hess and Fisher grade, occurrence of hydrocephalus, aneurysm location, time to surgery, delayed ischemic neurological deficit (DIND) and peak leukocyte of blood test from day 1 to 3 after aneurysmal rupture were recorded and analyzed. In the multivariable analysis model, gender, Fisher grade, time to surgery and hydrocephalus were not relevant to poor outcome. However, Hunt-Hess grade, DIND and preoperative leukocyte count (>13.84 × 10/L) were significantly associated with adverse outcome. The respective increased risks were 5.2- (OR5.24, 95% CI 1.67-16.50, p = 0.005), 6.2-(OR 6.24, 95% CI 3.55-10.99, p < 0.001) and 10.9-fold (OR 9.35, 95% CI 5.98-19.97, p < 0.001). The study revealed that Hunt-Hess grade, DIND and preoperative leukocyte count (>13.84 × 10/L) were independent risk factors for poor outcome of ruptured CA at 3 months. Higher leukocyte count is a convenient and useful marker to predict 3-month poor outcome for ruptured CA.
尚未完全确定白细胞是否可以预测破裂性脑动脉瘤（CA）的不良预后。在这里，我们回顾性分析了 2010 年至 2015 年间 428 例破裂性 CA 患者的临床资料。记录和分析了患者的人口统计学数据，包括性别、年龄、吸烟、饮酒、高血压、糖尿病和高胆固醇血症史、Hunt-Hess 和 Fisher 分级、脑积水的发生、动脉瘤位置、手术时间、迟发性缺血性神经功能缺损（DIND）以及从动脉瘤破裂后第 1 天到第 3 天的白细胞峰值。在多变量分析模型中，性别、Fisher 分级、手术时间和脑积水与不良结局无关。然而，Hunt-Hess 分级、DIND 和术前白细胞计数（>13.84×10/L）与不良预后显著相关。相应的风险增加分别为 5.2-（OR5.24，95%CI 1.67-16.50，p=0.005）、6.2-（OR 6.24，95%CI 3.55-10.99，p<0.001）和 10.9 倍（OR 9.35，95%CI 5.98-19.97，p<0.001）。研究表明，Hunt-Hess 分级、DIND 和术前白细胞计数（>13.84×10/L）是破裂性 CA 3 个月不良预后的独立危险因素。较高的白细胞计数是预测破裂性 CA 3 个月不良预后的一个方便且有用的标志物。
