Kim Yejin, Sohn Jong-Hee, Kim Chulho, Park So Young, Lee Sang-Hwa
Institute of New Frontier Research Team, Hallym University, Chuncheon 24252, Republic of Korea.
Department of Neurology, Hallym University Chuncheon Sacred Heart Hospital, Chuncheon 24252, Republic of Korea.
J Clin Med. 2023 Apr 20;12(8):3004. doi: 10.3390/jcm12083004.
There is little knowledge of the effect of inflammatory markers on the prognoses of hematoma expansion (HE) in patients with intracranial hemorrhage (ICH). We evaluated the impact of neutrophil-lymphocyte ratio (NLR) and platelet-lymphocyte ratio (PLR) on HE and worse outcomes after acute ICH. This study included 520 consecutive patients with ICH from the registry database enrolled over 80 months. Patients' whole blood samples were collected upon arrival in the emergency department. Brain computed tomography scans were performed during hospitalization and repeated at 24 h and 72 h. The primary outcome measure was HE, defined as relative growth >33% or absolute growth <6 mL. A total of 520 patients were enrolled in this study. Multivariate analysis showed that NLR and PLR were associated with HE (NLR: odds ratio [OR], [95% CI] = 1.19 [1.12-1.27], < 0.001; PLR: OR, [95% CI] = 1.01 [1.00-1.02], = 0.04). Receiver operating characteristic curve analysis revealed that NLR and PLR could predict HE (AUC of NLR: 0.84, 95% CI [0.80-0.88], < 0.001; AUC of PLR: 0.75 95% CI [0.70-0.80], < 0.001). The cut-off value of NLR for predicting HE was 5.63, and that of PLR was 23.4. Higher NLR and PLR values increase HE risk in patients with ICH. NLR and PLR were reliable for predicting HE after ICH.
关于炎症标志物对颅内出血（ICH）患者血肿扩大（HE）预后的影响，目前知之甚少。我们评估了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）对急性ICH后HE及不良预后的影响。本研究纳入了登记数据库中连续520例ICH患者，这些患者是在80个月内入组的。患者到达急诊科时采集全血样本。住院期间进行脑部计算机断层扫描，并在24小时和72小时重复扫描。主要结局指标为HE，定义为相对增长>33%或绝对增长<6 mL。本研究共纳入520例患者。多因素分析显示，NLR和PLR与HE相关（NLR：比值比[OR]，[95%置信区间] = 1.19 [1.12 - 1.27]，<0.001；PLR：OR，[95%置信区间] = 1.01 [1.00 - 1.02]，= 0.04）。受试者工作特征曲线分析显示NLR和PLR可预测HE（NLR的曲线下面积：0.84，95%置信区间[0.80 - 0.88]，<0.001；PLR的曲线下面积：0.75，95%置信区间[0.70 - 0.80]，<0.001）。预测HE的NLR临界值为5.63，PLR临界值为23.4。较高的NLR和PLR值会增加ICH患者的HE风险。NLR和PLR对预测ICH后的HE是可靠的。
