高中性粒细胞与血小板比值与自发性脑出血患者血肿扩大相关：一项回顾性研究。
A high neutrophil-to-platelet ratio is associated with hematoma expansion in patients with spontaneous intracerebral hemorrhage: a retrospective study.
机构信息
Department of Neurosurgery, West China Hospital, Sichuan University, 37 Guo Xue Xiang, Wu Hou District, 610041, Chengdu, P.R. China.
Department of Intensive Care Unit, Fourth People's Hospital of Sichuan Province, Chengdu, P.R. China.
出版信息
BMC Neurol. 2023 Jan 18;23(1):27. doi: 10.1186/s12883-023-03055-3.
BACKGROUND
Early hematoma expansion (HE) occurs in 20 to 40% of spontaneous intracerebral hemorrhage (ICH) patients and is a primary determinant of early deterioration and poor prognosis. Previous studies have shown that inflammation is a major pathological feature of ICH, and the neutrophil-to-platelet ratio (NPR) is a marker of systemic inflammation. Therefore, we aimed to assess the association between the NPR and HE in ICH patients.
METHODS
We retrospectively collected and analyzed data from ICH patients who received treatment at our institution from January 2018 to November 2019. The NPR was calculated from the admission blood test. Brain computed tomography (CT) scans were performed at admission and repeated within 24 h. Hematoma growth was defined as relative growth > 33% or absolute growth > 6 ml.
RESULTS
A total of 317 patients were enrolled in our study. Multivariate logistic regression analysis indicated that the NPR was an independent predictor of HE [odds ratio (OR) = 1.742; 95% CI: 1.508-2.012, p < 0.001]. Receiver operating characteristic (ROC) curve analysis revealed that the NPR could predict HE, with an area under the curve of 0.838 (95% CI, 0.788-0.888, p < 0.001). The best predictive cut-off of the NPR for HE was 5.47 (sensitivity, 75.3%; specificity, 77.6%).
CONCLUSIONS
A high NPR was associated with an increased risk of HE in patients with ICH.
背景
自发性脑出血（ICH）患者中有 20%至 40%会发生早期血肿扩大（HE），且早期恶化和预后不良的主要决定因素就是血肿扩大。既往研究表明，炎症是 ICH 的主要病理特征，中性粒细胞与血小板比值（NPR）是全身炎症的标志物。因此，我们旨在评估 ICH 患者中 NPR 与 HE 之间的关系。
方法
我们回顾性收集了 2018 年 1 月至 2019 年 11 月在我院接受治疗的 ICH 患者的数据并进行了分析。NPR 通过入院时的血液检查计算得出。入院时进行脑计算机断层扫描（CT）检查，并在 24 小时内重复检查。血肿增长定义为相对增长>33%或绝对增长>6ml。
结果
共有 317 例患者纳入本研究。多变量逻辑回归分析表明，NPR 是 HE 的独立预测因素[比值比（OR）=1.742；95%可信区间：1.508-2.012，p<0.001]。受试者工作特征（ROC）曲线分析显示，NPR 可预测 HE，曲线下面积为 0.838（95%可信区间：0.788-0.888，p<0.001）。NPR 预测 HE 的最佳截断值为 5.47（灵敏度，75.3%；特异性，77.6%）。
结论
NPR 升高与 ICH 患者发生 HE 的风险增加有关。
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