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术后第 3 天的全身免疫炎症指数和系统炎症反应指数可预测动脉瘤性蛛网膜下腔出血患者的不良预后。

Systemic immune inflammation index and system inflammation response index on the third postoperative day predict poor prognosis of aneurysmal subarachnoid hemorrhage patients.

机构信息

Department of Pharmacy, The First Affiliated Hospital of Yangtze University, Jingzhou, China.

The Neurointensive Care Unit, The First Affiliated Hospital of Yangtze University, Jingzhou, China.

出版信息

Medicine (Baltimore). 2024 Apr 19;103(16):e37818. doi: 10.1097/MD.0000000000037818.

Abstract

The inflammatory response is involved in the progression of aneurysmal subarachnoid hemorrhage (aSAH). We sought to investigate the relationships of inflammatory indicators including blood cell counts and the ratios of different blood cells counts with the prognosis of aSAH patients. We performed a retrospective study including 140 patients with aSAH and aneurysm surgeries. The relationships of neutrophils, lymphocytes, monocytes, platelets, systemic immune inflammation index (SII), system inflammation response index (SIRI), neutrophil-lymphocyte ratio and platelet-lymphocyte ratio with prognosis were investigated by univariable analysis and multivariable logistic regression model. The patient with Modified Rankin Scale (mRS) score<3 was defined as having a good prognosis, while with mRS score ≥3 was defined as having a poor prognosis. Among 140 patients included, there were 108 cases with good prognosis and 32 cases with poor prognosis after follow-up. On the 3rd postoperative day, the neutrophils counts, SIRI level and SII level in cases with poor prognosis were significantly higher than cases with good prognosis, P < .05. After adjusting for baseline differences in Hunt-Hess grade, Glasgow Coma Scale score, combination with intraventricular hemorrhage and maximum diameter of aneurysm, the levels of SIRI (odds ratio = 3.968, 95% CI: 1.432-10.992, P = .008) and SII (odds ratio = 3.313, 95% CI: 1.029-10.665, P = .045) on the 3rd postoperative day could predict poor prognosis. SII and SIRI on the 3rd postoperative day could independently predict the poor prognosis in aSAH. However, the cutoff values for predicting prognosis needs to be validated in larger-sample studies.

摘要

炎症反应参与了颅内动脉瘤性蛛网膜下腔出血(aSAH)的进展。我们试图研究炎症指标,包括血细胞计数和不同血细胞计数的比例与 aSAH 患者预后的关系。我们进行了一项回顾性研究,纳入了 140 例接受 aSAH 和动脉瘤手术的患者。通过单变量分析和多变量逻辑回归模型,研究了中性粒细胞、淋巴细胞、单核细胞、血小板、全身免疫炎症指数(SII)、全身炎症反应指数(SIRI)、中性粒细胞-淋巴细胞比值和血小板-淋巴细胞比值与预后的关系。改良 Rankin 量表(mRS)评分<3 定义为预后良好,mRS 评分≥3 定义为预后不良。在纳入的 140 例患者中,随访后有 108 例预后良好,32 例预后不良。术后第 3 天,预后不良组的中性粒细胞计数、SIRI 水平和 SII 水平明显高于预后良好组,P<0.05。在调整基线差异后,Hunt-Hess 分级、格拉斯哥昏迷评分、合并脑室内出血和最大动脉瘤直径,术后第 3 天 SIRI(比值比=3.968,95%可信区间:1.432-10.992,P=0.008)和 SII(比值比=3.313,95%可信区间:1.029-10.665,P=0.045)水平可预测不良预后。术后第 3 天的 SII 和 SIRI 可独立预测 aSAH 的不良预后。然而,预测预后的截断值需要在更大样本的研究中验证。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/0bca/11030023/d9a5aa6d5574/medi-103-e37818-g001.jpg

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