中性粒细胞与淋巴细胞比值及血小板与淋巴细胞比值在急性脑出血合并消化道出血中的临床意义及危险因素的logistic回归分析
Clinical significance of neutrophil to lymphocyte ratio and platelet to lymphocyte ratio in acute cerebral hemorrhage with gastrointestinal hemorrhage, and logistic regression analysis of risk factors.
作者信息
Zou Yu, Zhang Wei, Huang Chuanjun, Zhu Yangqing
机构信息
Department of Neurosurgery, The First People's Hospital of Wujiang District, Suzhou, Jiangsu 215200, P.R. China.
出版信息
Exp Ther Med. 2019 Sep;18(3):1533-1538. doi: 10.3892/etm.2019.7778. Epub 2019 Jul 17.
The aim of the present study was to determine the predictive value of the neutrophil to lymphocyte ratio (NLR) and platelet to lymphocyte ratio (PLR) in patients with acute cerebral hemorrhage with or without gastrointestinal hemorrhage. Risk factors of gastrointestinal hemorrhage in patients with acute cerebral hemorrhage were also assessed. A total of 335 patients with acute cerebral hemorrhage admitted to our hospital between January 2012 and January 2017 were enrolled. The 86 patients who experienced gastrointestinal hemorrhage during hospitalization were selected as the observation group, while the 249 remaining cases were assigned to the negative control group. The neutrophil, white blood cell and platelet count, as well as the NLR and PLR of each subject were recorded. Furthermore, sex, age, blood pressure, the site of cerebral hemorrhage, the amount of bleeding, the Glasgow Coma Scale (GCS) score and presence of hematosepsis were also recorded and assessed as potential risk factors for gastrointestinal hemorrhage in patients with acute cerebral hemorrhage. The NLR and PLR were markedly higher in the observation group compared with those in the negative control group. Furthermore, the NLR and PLR in the observation group were negatively associated with the 90-day overall survival of patients with acute cerebral hemorrhage and gastrointestinal hemorrhage. In the negative control group, only the PLR was negatively associated with overall survival. Logistic regression analysis indicated that a cerebral hemorrhage volume of >30 ml, lower GCS score and hematosepsis were independently associated with gastrointestinal hemorrhage in patients with acute cerebral hemorrhage (P<0.05). A high NLR and PLR indicated an elevated risk of gastrointestinal hemorrhage in patients with acute cerebral hemorrhage. A higher NLR and PLR were also negatively associated with overall survival and prognosis of patients with cerebral hemorrhage. In addition, a cerebral hemorrhage volume of >30 ml, lower GCS score and hematosepsis were independent risk factors of gastrointestinal hemorrhage in patients with acute cerebral hemorrhage.
本研究的目的是确定中性粒细胞与淋巴细胞比值（NLR）和血小板与淋巴细胞比值（PLR）在伴或不伴胃肠道出血的急性脑出血患者中的预测价值。同时还评估了急性脑出血患者发生胃肠道出血的危险因素。选取了2012年1月至2017年1月期间我院收治的335例急性脑出血患者。将住院期间发生胃肠道出血的86例患者选为观察组，其余249例患者分配至阴性对照组。记录了每位受试者的中性粒细胞、白细胞和血小板计数，以及NLR和PLR。此外，还记录并评估了性别、年龄、血压、脑出血部位、出血量、格拉斯哥昏迷量表（GCS）评分和败血症情况，将其作为急性脑出血患者发生胃肠道出血的潜在危险因素。观察组的NLR和PLR明显高于阴性对照组。此外，观察组的NLR和PLR与急性脑出血合并胃肠道出血患者的90天总生存率呈负相关。在阴性对照组中，仅PLR与总生存率呈负相关。Logistic回归分析表明，脑出血量>30 ml、较低的GCS评分和败血症与急性脑出血患者发生胃肠道出血独立相关（P<0.05）。高NLR和PLR表明急性脑出血患者发生胃肠道出血的风险升高。较高的NLR和PLR也与脑出血患者的总生存率和预后呈负相关。此外，脑出血量>30 ml、较低的GCS评分和败血症是急性脑出血患者发生胃肠道出血的独立危险因素。
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