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淋巴细胞与单核细胞比值是自发性脑出血患者神经功能恶化及 90 天死亡率的独立预测因子。

Lymphocyte-to-Monocyte Ratio Is an Independent Predictor for Neurological Deterioration and 90-Day Mortality in Spontaneous Intracerebral Hemorrhage.

机构信息

Department of Neurosurgery, Ulanqab Central Hospital, Ulanqab, Inner Mongolia, China (mainland).

Department of Neurology, Inner Mongolia People's Hospital, Hohhot, Inner Mongolia, China (mainland).

出版信息

Med Sci Monit. 2018 Dec 20;24:9282-9291. doi: 10.12659/MSM.911645.

Abstract

BACKGROUND Lymphocyte-to-monocyte ratio (LMR) is an independent predictive factor of clinical outcome of acute ischemic stroke and cancer, but the predictive effect of LMR in spontaneous intracerebral hemorrhage (ICH) is unknown. Thus, the aim of this study was to explore the impact of peripheral LMR on the neurological deterioration (ND) during the initial week after spontaneous ICH onset, as well as 90-day mortality. MATERIAL AND METHODS The clinical data of 558 consecutive patients with ICH were retrospectively analyzed. LMR is calculated by absolute lymphocyte count divided by absolute monocyte count. RESULTS Of these patients, 166 patients experienced ND during the first week after admission and 72 patients died within 90 days. Multivariate analysis indicated that white blood cells (WBC), absolute neutrophil count (ANC), absolute lymphocyte count (ALC), neutrophil-to-lymphocyte ratio (NLR), LMR were significantly associated with ND during the initial week after ICH onset and also were associated with 90-day mortality. Moreover, NLR and LMR showed a higher predictive ability in ND during the initial week after ICH onset than 90-day mortality in receiver operating characteristic analysis. The best cut-off points of NLR and LMR in predicting ND and 90-day mortality were 10.24 and 2.21 and 16.81 and 2.19, respectively. CONCLUSIONS Our results suggest that LMR on admission is a predictive factor for ND during the initial week after ICH onset, as well as 90-day mortality.

摘要

背景

淋巴细胞与单核细胞比值(LMR)是急性缺血性卒中和癌症临床结局的独立预测因素,但外周血 LMR 在自发性脑出血(ICH)中的预测作用尚不清楚。因此,本研究旨在探讨入院时外周血 LMR 对自发性 ICH 发病后最初一周内神经功能恶化(ND)的影响,以及 90 天死亡率。

材料与方法

回顾性分析了 558 例连续 ICH 患者的临床资料。LMR 通过绝对淋巴细胞计数除以绝对单核细胞计数计算得出。

结果

在这些患者中,166 例在入院后第一周内发生 ND,72 例在 90 天内死亡。多变量分析表明,白细胞(WBC)、绝对中性粒细胞计数(ANC)、绝对淋巴细胞计数(ALC)、中性粒细胞与淋巴细胞比值(NLR)、LMR 与 ICH 发病后最初一周内的 ND 显著相关,也与 90 天死亡率相关。此外,NLR 和 LMR 在预测 ICH 发病后最初一周内的 ND 方面比在接受者操作特征分析中预测 90 天死亡率具有更高的预测能力。NLR 和 LMR 预测 ND 和 90 天死亡率的最佳截断点分别为 10.24 和 2.21 以及 16.81 和 2.19。

结论

我们的研究结果表明,入院时的 LMR 是 ICH 发病后最初一周内 ND 以及 90 天死亡率的预测因素。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/0d63/6320655/ede4555a49bc/medscimonit-24-9282-g001.jpg

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