Early increased neutrophil-to-lymphocyte ratio is associated with poor 3-month outcomes in spontaneous intracerebral hemorrhage
Early increased neutrophil-to-lymphocyte ratio is associated with poor 3-month outcomes in spontaneous intracerebral hemorrhage
复制标题
早期增加的中性粒细胞与淋巴细胞比率与自发性脑出血的 3 个月预后不良相关
DOI：
10.1371/journal.pone.0211833
复制
发表时间：
2019-02-07
期刊：
影响因子：
3.7
通讯作者：
Xu, Yuming
中科院分区：
文献类型：
--
作者：
Qin, Jie;Li, Zhu;Xu, Yuming
本研究的目的是评估动态中性粒细胞/淋巴细胞比率(NLR)与SICH患者3个月功能预后的关系。我们回顾了2017年1月至2018年5月在郑州大学第一附属医院住院的连续213例SICH患者。根据3个月的结果将患者分为功能独立性(FI)组和预后不良(UP)组。取发病24小时内入院时的白细胞计数，以中性粒细胞为分子、淋巴细胞为分母的记录分数为NLR0。分别于第1天(n=77)、第3天(n=126)、第7天(n=123)和第14天(n=105)记录NLR1、NLR3、NLR7和NLR14。用Spearman‘s或Kendall’s相关分析评价动态NLR或白细胞计数与临床特征的关系。采用Logistic回归分析3个月预后不良的危险因素。患者入院时的NLR动态变化与美国国立卫生研究院卒中评分、脑出血评分、血肿量呈正相关，而与3个月后的GCS评分、FI呈负相关。此外，入院时较高的中性粒细胞受体或较低的淋巴细胞绝对计数是3个月以上的独立危险因素(调整后的优势比[OR]：1.0 6，95%可信区间[CI]：1.003，1.12；OR：0.41，95%CI：0.18，0.94)。总而言之，早期较高的NLR和较低的淋巴细胞计数预示着SICH患者3个月的不良预后。
The aim of this study was to evaluate the association of dynamic neutrophil-to-lymphocyte ratio (NLR) with 3-month functional outcomes in patients with sICH. We retrospectively identified 213 consecutive patients with sICH hospitalized in The First Affiliated Hospital of Zhengzhou University from January 2017 to May 2018. Patients were divided into functional independence (FI) or unfavorable prognosis (UP) groups based on 3-month outcomes. Admission leukocyte counts within 24 hours of symptom onset were obtained, and the recorded fraction, of which the numerator is neutrophil and the denominator is lymphocyte, as NLR0. Determined NLR1, NLR3, NLR7, and NLR14 were recorded on day 1 (n = 77), day 3 (n = 126), day 7 (n = 123), and day 14 (n = 105), respectively. The relationships between dynamic NLR or leukocyte counts and clinical features were evaluated using Spearman's or Kendall's correlation analysis. Logistic regression analyses were used to identify the risk factors for unfavorable 3-month prognosis. The patients' dynamic NLR was positively associated with the National Institutes of Health Stroke Scale, ICH score, and hematoma volume at admission, while inversely correlated to the onset GCS score and FI at 3-month follow-up. Furthermore, higher NLR or lower absolute lymphocyte count obtained at admission was independently risk factor for UP at 3 months (adjusted odds ratio [OR]: 1.06, 95% confidence interval [CI]: 1.003, 1.12; OR: 0.41, 95% CI: 0.18, 0.94, respectively). In conclusion, higher NLR and lower lymphocyte counts at early stages were predictive of 3-month unfavorable outcomes in sICH patients.