Research Center of Translational Medicine, Second Affiliated Hospital of Shantou University Medical College, Shantou, Guangdong, China.
Department of Neurosurgery, First Affiliated Hospital of Shantou University Medical College, Shantou, Guangdong, China.
Front Immunol. 2024 Mar 12;15:1336862. doi: 10.3389/fimmu.2024.1336862. eCollection 2024.
Neutrophil-to-lymphocyte ratio (NLR) and monocyte-to-lymphocyte ratio (MLR) have been identified as potential prognostic markers in various conditions, including cancer, cardiovascular disease, and stroke. This study aims to investigate the dynamic changes of NLR and MLR following cerebral contusion and their associations with six-month outcomes.
Retrospective data were collected from January 2016 to April 2020, including patients diagnosed with cerebral contusion and discharged from two teaching-oriented tertiary hospitals in Southern China. Patient demographics, clinical manifestations, laboratory test results (neutrophil, monocyte, and lymphocyte counts) obtained at admission, 24 hours, and one week after cerebral contusion, as well as outcomes, were analyzed. An unfavorable outcome was defined as a Glasgow Outcome Score (GOS) of 0-3 at six months. Logistic regression analysis was performed to identify independent predictors of prognosis, while receiver characteristic curve analysis was used to determine the optimal cutoff values for NLR and MLR.
A total of 552 patients (mean age 47.40, SD 17.09) were included, with 73.19% being male. Higher NLR at one-week post-cerebral contusion (adjusted OR = 4.19, 95%CI, 1.16 - 15.16, = 0.029) and higher MLR at admission and at 24 h (5.80, 1.40 - 24.02, = 0.015; 9.06, 1.45 - 56.54, = 0.018, respectively) were significantly associated with a 6-month unfavorable prognosis after adjustment for other risk factors by multiple logistic regression. The NLR at admission and 24 hours, as well as the MLR at one week, were not significant predictors for a 6-month unfavorable prognosis. Based on receiver operating characteristic curve analysis, the optimal thresholds of NLR at 1 week and MLR at admission after cerebral contusion that best discriminated a unfavorable outcome at 6-month were 6.39 (81.60% sensitivity and 70.73% specificity) and 0.76 (55.47% sensitivity and 78.26% specificity), respectively.
NLR measured one week after cerebral contusion and MLR measured at admission may serve as predictive markers for a 6-month unfavorable prognosis. These ratios hold potential as parameters for risk stratification in patients with cerebral contusion, complementing established biomarkers in diagnosis and treatment. However, further prospective studies with larger cohorts are needed to validate these findings.
中性粒细胞与淋巴细胞比值（NLR）和单核细胞与淋巴细胞比值（MLR）已被确定为癌症、心血管疾病和中风等多种情况下的潜在预后标志物。本研究旨在探讨脑挫裂伤后 NLR 和 MLR 的动态变化及其与 6 个月预后的关系。
回顾性收集 2016 年 1 月至 2020 年 4 月期间，来自中国南方两家教学型三级医院的脑挫裂伤患者的临床资料。分析患者的人口统计学、临床表现、入院时及脑挫裂伤后 24 小时和 1 周的实验室检查结果（中性粒细胞、单核细胞和淋巴细胞计数）以及结局。预后不良定义为 6 个月时格拉斯哥预后评分（GOS）为 0-3。采用 logistic 回归分析确定预后的独立预测因素，采用受试者工作特征曲线分析确定 NLR 和 MLR 的最佳截断值。
共纳入 552 例患者（平均年龄 47.40 岁，标准差 17.09 岁），其中 73.19%为男性。脑挫裂伤后 1 周 NLR 较高（调整后的 OR = 4.19，95%CI，1.16-15.16， = 0.029）和入院时及 24 小时时 MLR 较高（5.80，1.40-24.02， = 0.015；9.06，1.45-56.54， = 0.018）与调整其他危险因素后的 6 个月预后不良显著相关。入院时和 24 小时的 NLR 以及 1 周的 MLR 不是 6 个月预后不良的显著预测因素。基于受试者工作特征曲线分析，脑挫裂伤后 1 周 NLR 和入院时 MLR 的最佳截断值分别为 6.39（81.60%的敏感性和 70.73%的特异性）和 0.76（55.47%的敏感性和 78.26%的特异性），可最佳区分 6 个月的不良预后。
脑挫裂伤后 1 周测定的 NLR 和入院时测定的 MLR 可能是 6 个月预后不良的预测标志物。这些比值可能成为脑挫裂伤患者风险分层的参数，补充了诊断和治疗中的现有生物标志物。但是，需要更大样本量的前瞻性研究来验证这些发现。
