Third Department of Neurology and Key Disciplines Laboratory of Clinical Medicine of Henan Province, The First Affiliated Hospital of Zhengzhou University, Zhengzhou, Henan, P. R. China.
Department of Immunology, College of Basic Medical Sciences, Zhengzhou University, Zhengzhou, Henan, P. R. China.
PLoS One. 2019 Feb 7;14(2):e0211833. doi: 10.1371/journal.pone.0211833. eCollection 2019.
The aim of this study was to evaluate the association of dynamic neutrophil-to-lymphocyte ratio (NLR) with 3-month functional outcomes in patients with sICH. We retrospectively identified 213 consecutive patients with sICH hospitalized in The First Affiliated Hospital of Zhengzhou University from January 2017 to May 2018. Patients were divided into functional independence (FI) or unfavorable prognosis (UP) groups based on 3-month outcomes. Admission leukocyte counts within 24 hours of symptom onset were obtained, and the recorded fraction, of which the numerator is neutrophil and the denominator is lymphocyte, as NLR0. Determined NLR1, NLR3, NLR7, and NLR14 were recorded on day 1 (n = 77), day 3 (n = 126), day 7 (n = 123), and day 14 (n = 105), respectively. The relationships between dynamic NLR or leukocyte counts and clinical features were evaluated using Spearman's or Kendall's correlation analysis. Logistic regression analyses were used to identify the risk factors for unfavorable 3-month prognosis. The patients' dynamic NLR was positively associated with the National Institutes of Health Stroke Scale, ICH score, and hematoma volume at admission, while inversely correlated to the onset GCS score and FI at 3-month follow-up. Furthermore, higher NLR or lower absolute lymphocyte count obtained at admission was independently risk factor for UP at 3 months (adjusted odds ratio [OR]: 1.06, 95% confidence interval [CI]: 1.003, 1.12; OR: 0.41, 95% CI: 0.18, 0.94, respectively). In conclusion, higher NLR and lower lymphocyte counts at early stages were predictive of 3-month unfavorable outcomes in sICH patients.
本研究旨在评估动态中性粒细胞与淋巴细胞比值（NLR）与 sICH 患者 3 个月功能结局的相关性。我们回顾性纳入 2017 年 1 月至 2018 年 5 月郑州大学第一附属医院收治的 213 例 sICH 患者。根据 3 个月结局将患者分为功能独立（FI）或预后不良（UP）组。发病 24 小时内获得白细胞计数，记录的分数，分子为中性粒细胞，分母为淋巴细胞，作为 NLR0。分别记录入院第 1 天（n = 77）、第 3 天（n = 126）、第 7 天（n = 123）及第 14 天（n = 105）的 NLR1、NLR3、NLR7 和 NLR14。采用 Spearman 或 Kendall 相关分析评估动态 NLR 或白细胞计数与临床特征的关系。采用 Logistic 回归分析确定 3 个月预后不良的危险因素。患者的动态 NLR 与 NIHSS 评分、ICH 评分和入院时血肿体积呈正相关，与发病时 GCS 评分和 3 个月时 FI 呈负相关。此外，入院时 NLR 升高或绝对淋巴细胞计数降低是 3 个月 UP 的独立危险因素（调整后的比值比[OR]：1.06，95%置信区间[CI]：1.003，1.12；OR：0.41，95%CI：0.18，0.94）。总之，早期 NLR 升高和淋巴细胞计数降低是 sICH 患者 3 个月不良结局的预测因素。
