中性粒细胞与白蛋白比值作为动脉瘤性蛛网膜下腔出血后迟发性脑缺血的生物标志物。
Neutrophil-to-Albumin Ratio as a Biomarker of Delayed Cerebral Ischemia After Aneurysmal Subarachnoid Hemorrhage.
机构信息
Lianyungang Clinical College of Nanjing Medical University, Lianyungang, China.
Qingpu Branch of Zhongshan Hospital Affiliated to Fudan University, Shanghai, China.
出版信息
World Neurosurg. 2021 Mar;147:e453-e458. doi: 10.1016/j.wneu.2020.12.084. Epub 2020 Dec 26.
OBJECTIVE
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).
METHODS
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.
RESULTS
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).
CONCLUSIONS
NAR, in positive correlation with the severity of hemorrhage, appears to be a novel predictive biomarker of DCI after aSAH.
目的
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。
方法
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。
结果
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）。
结论
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。
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