Lianyungang Clinical College of Nanjing Medical University, Lianyungang, China.
Qingpu Branch of Zhongshan Hospital Affiliated to Fudan University, Shanghai, China.
World Neurosurg. 2021 Mar;147:e453-e458. doi: 10.1016/j.wneu.2020.12.084. Epub 2020 Dec 26.
This study set out to investigate the relationships between the neutrophil-to-albumin ratio (NAR) in the early stages of aneurysmal subarachnoid hemorrhage (aSAH) and the occurrence of delayed cerebral ischemia (DCI).
A total of 439 patients with aSAH were included in this retrospective study. NAR assessment was conducted on admission. The relationship between NAR and DCI was analyzed.
Eighty-four patients (23.7%) experienced DCI. NAR levels were significantly higher in patients with DCI after aSAH than without DCI (median [interquartile range] 0.350 [0.274-0.406] vs. 0.240 [0.186-0.300]; P < 0.001). NAR levels were correlated with World Federation of Neurological Surgeons (WFNS) grade and modified Fisher (mFisher) grade (r = 0.505 and 0.394, respectively). NAR and mFisher grade were the independent predictors of DCI. Under receiver operating characteristic curve, NAR levels exhibited a significant discriminatory capability (area under the curve [95% confidence interval] 0.812 [0.740-0.823]; P < 0.001). The predictive power of NAR levels was similar to mFisher grade (P > 0.05).
NAR, in positive correlation with the severity of hemorrhage, appears to be a novel predictive biomarker of DCI after aSAH.
本研究旨在探讨动脉瘤性蛛网膜下腔出血（aSAH）早期中性粒细胞与白蛋白比值（NAR）与迟发性脑缺血（DCI）发生的关系。
本回顾性研究纳入了 439 例 aSAH 患者。入院时进行 NAR 评估。分析 NAR 与 DCI 的关系。
84 例（23.7%）患者发生 DCI。DCI 后 aSAH 患者的 NAR 水平明显高于无脑 DCI 患者（中位数[四分位数间距] 0.350[0.274-0.406] vs. 0.240[0.186-0.300]；P<0.001）。NAR 水平与世界神经外科学会（WFNS）分级和改良 Fisher（mFisher）分级呈正相关（r分别为 0.505 和 0.394）。NAR 和 mFisher 分级是 DCI 的独立预测因子。在受试者工作特征曲线下，NAR 水平具有显著的区分能力（曲线下面积[95%置信区间] 0.812[0.740-0.823]；P<0.001）。NAR 水平的预测能力与 mFisher 分级相似（P>0.05）。
NAR 与出血严重程度呈正相关，似乎是 aSAH 后 DCI 的一种新的预测生物标志物。
