中性粒细胞与淋巴细胞比值与吉兰-巴雷综合征患者临床严重程度的关系。
Relation of Neutrophil-Lymphocyte Ratio with Clinical Severity in Patients with Guillain-Barre Syndrome.
机构信息
Dr Shubhrangshu Banerjee, Indoor Medical Officer, Neurology, Mymensingh Medical College Hospital (MMCH), Mymensingh, Bangladesh; E-mail:
出版信息
Mymensingh Med J. 2023 Jul;32(3):599-605.
Guillain-Barre syndrome (GBS) is an acute autoimmune polyradiculoneuropathy. Neutrophil-lymphocyte ratio (NLR) is a novel prognostic and inflammatory marker in patients with neurological diseases. The study was designed to observe the relation between neutrophil lymphocyte ratio and the clinical severity in patients with Guillain-Barre Syndrome (GBS). This cross-sectional descriptive study was conducted at the department of Neurology and Medicine, Mymensingh Medical College and Hospital from April 2019 to September 2020. Total 58 patients with GBS were enrolled according to the inclusion and exclusion criteria within 7 days of development of symptoms. The clinical diagnosis of GBS was done according to Ausbury and Cornblath's diagnostic criteria; moreover clinical severity was done according to Hughes and Rees scale, Medical Research Council (MRC) grade, cranial nerve involvement and autonomic involvement. After measuring complete blood count, NLR was calculated by dividing neutrophil count to lymphocyte count. Data analysis was done on SPSS 23.0. Mean age of the GBS patients was 36.21±11.55 years. Among 58 respondents 70.69% (41) were male and 29.31% (17) were female. Most of the patients had a GBS severity score of 4(62.07%) followed by 3(27.59%) and 5(10.34%). The mean NLR of the respondents was 3.22±2.25. Acute motor axonal neuropathy (AMAN) was in 48.28% respondents and their mean NLR was 3.89±0.31, 31.03% had AIDP and mean NLR was 3.28±0.46 and 20.69% had Acute motor sensory axonal neuropathy (AMSAN) and mean NLR was 4.5±0.52. The mean NLR of the MRC grade 0, 1, 2, 3 patients was 6.61±1.78, 3.39±0.92, 2.71±1.39 and 1.45±0.40 respectively. Hughes score had a positive correlation (r=0.5333 and p<0.01) and MRC grade had a negative correlation (r= - 0.76805 and p<0.01) with NLR. Severity of GBS was significantly associated with raised NLR. Increase Hughes and Rees scale and decrease MRC grade also related to increased NLR.
格林-巴利综合征（GBS）是一种急性自身免疫性多神经根神经病。中性粒细胞与淋巴细胞比值（NLR）是一种新的神经疾病预后和炎症标志物。本研究旨在观察中性粒细胞与淋巴细胞比值与格林-巴利综合征（GBS）患者临床严重程度的关系。本横断面描述性研究于 2019 年 4 月至 2020 年 9 月在孟加拉国迈门辛医科大学和医院神经内科进行。根据纳入和排除标准，在症状出现后 7 天内共纳入 58 例 GBS 患者。根据奥萨伯里和康布拉斯的诊断标准进行 GBS 的临床诊断；此外，根据休斯和里斯量表、医学研究委员会（MRC）分级、颅神经受累和自主神经受累进行临床严重程度评估。测量全血细胞计数后，通过将中性粒细胞计数除以淋巴细胞计数计算 NLR。数据分析采用 SPSS 23.0 进行。GBS 患者的平均年龄为 36.21±11.55 岁。58 名受访者中，70.69%（41 名）为男性，29.31%（17 名）为女性。大多数患者的 GBS 严重程度评分为 4 分（62.07%），其次为 3 分（27.59%）和 5 分（10.34%）。受访者的平均 NLR 为 3.22±2.25。急性运动轴索性神经病（AMAN）占 48.28%，平均 NLR 为 3.89±0.31，31.03%为急性运动感觉轴索性神经病（AMSAN），平均 NLR 为 4.5±0.52，20.69%为急性运动感觉轴索性神经病（AMSAN），平均 NLR 为 3.28±0.46。MRC 分级 0、1、2、3 患者的平均 NLR 分别为 6.61±1.78、3.39±0.92、2.71±1.39 和 1.45±0.40。Hughes 评分与 NLR 呈正相关（r=0.5333，p<0.01），MRC 分级与 NLR 呈负相关（r=-0.76805，p<0.01）。GBS 的严重程度与 NLR 升高显著相关。Hughes 和 Rees 评分升高和 MRC 分级降低也与 NLR 升高有关。
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