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脑挫裂伤后单核细胞与淋巴细胞比值与血肿进展的相关性。

Association Between Monocyte-to-Lymphocyte Ratio and Hematoma Progression After Cerebral Contusion.

机构信息

Department of Neurosurgery, Affiliated Hospital of Yangzhou University, 45 Taizhou Road, Guangling District, Yangzhou City, Jiangsu Province, China.

Graduate School of Dalian Medical University, Dalian, Liaoning, China.

出版信息

Neurocrit Care. 2024 Jun;40(3):953-963. doi: 10.1007/s12028-023-01857-4. Epub 2023 Oct 17.

Abstract

BACKGROUND

The objective of this research was to examine the impact of the monocyte-to-lymphocyte ratio (MLR) on the advancement of hematoma after cerebral contusion.

METHODS

The clinical information and laboratory test findings of people with cerebral contusion were retrospectively analyzed. Using the tertiles of MLR, the study participants were categorized into three groups, enabling the evaluation of the correlation between MLR and the advancement of hematoma after cerebral contusion.

RESULTS

Among the cohort of patients showing progression, MLR levels were significantly higher compared with the nonprogress group (P < 0.001). The high MLR group had a significantly higher proportion of patients with hematoma progression compared with the medium and low MLR groups. However, the medium MLR group had a lower proportion of patients with hematoma progression compared with the low MLR group. High MLR levels were independently linked to a higher risk of hematoma progression (Odds Ratio 3.546, 95% Confidence Interval 1.187-10.597, P = 0.024). By incorporating factors such as Glasgow Coma Scale score on admission, anticoagulant/antiplatelet therapy, white blood cell count, and MLR into the model, the predictive performance of the model significantly improved (area under the curve 0.754).

CONCLUSIONS

Our study suggests that MLR may serve as a potential indicator for predicting the progression of hematoma after cerebral contusion. Further research is necessary to investigate the underlying pathological and physiological mechanisms that contribute to the association between MLR and the progression of hematoma after cerebral contusion and to explore its clinical implications.

摘要

背景

本研究旨在探讨单核细胞与淋巴细胞比值(MLR)对脑挫裂伤后血肿进展的影响。

方法

回顾性分析脑挫裂伤患者的临床资料和实验室检查结果。采用 MLR 的三分位数,将研究对象分为三组,评估 MLR 与脑挫裂伤后血肿进展的相关性。

结果

在进展组患者中,MLR 水平明显高于非进展组(P<0.001)。高 MLR 组中血肿进展的患者比例明显高于中、低 MLR 组,而中 MLR 组中血肿进展的患者比例明显低于低 MLR 组。高 MLR 水平与血肿进展的风险增加独立相关(优势比 3.546,95%置信区间 1.187-10.597,P=0.024)。将格拉斯哥昏迷量表评分、抗凝/抗血小板治疗、白细胞计数和 MLR 等因素纳入模型后,模型的预测性能显著提高(曲线下面积 0.754)。

结论

本研究表明,MLR 可能是预测脑挫裂伤后血肿进展的潜在指标。需要进一步研究探讨 MLR 与脑挫裂伤后血肿进展之间的关联的潜在病理生理机制,并探索其临床意义。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/e931/11147937/6fd0a031ce59/12028_2023_1857_Fig1_HTML.jpg

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