【摘要】 目的探索中性粒细胞与淋巴细胞比值(NLR)与重型颅脑损伤(STBI)的关系以及对STBI患者短期预后的预测价值。方法选取STBI患者(外伤组)与健康体检者(对照组)各126例,比较两组NLR,分析STBI患者临床特征与NLR的关系,NLR与1周死亡、6个月死亡和6个月神经功能预后不良[格拉斯哥昏迷评分(GCS)1~3分]的关系及预测价值。结果外伤组NLR明显高于对照组(P<0.01),NLR与STBI患者受伤时GCS呈显著负相关(r=-5.120,P<0.01)。NLR是外伤后1周死亡(OR=2.051,95%CI:1.051~4.005)、6个月死亡(OR=2.047,95%CI:1.233~3.397)和6个月预后不良(OR=2.113,95%CI:1.329~3.360)的独立危险因素。NLR预测外伤后1周死亡(AUC=0.807,95%CI:0.727~0.871)、6个月死亡(AUC=0.813,95%CI:0.734~0.877)和6个月预后不良(AUC=0.804,95%CI:0.724~0.869)的价值较大。NLR与GCS对STBI预后的预测价值比较,差异无统计学意义(P>0.05)。结论 STBI患者NLR明显升高,与STBI受伤时GCS呈负相关;NLR与STBI患者短期死亡和神经功能预后不良密切相关,具有临床预测价值。更多还原

【Abstract】 Objective To investigate the relationship between neutrophil to lymphocyte ratio(NLR)and prognosis of severe traumatic brain injury(STBI).Methods One hundred and twenty six STBI patients(trauma group) and 126 healthy individuals(control group) were recruited.The NLR value was compared between two groups.The correlation of NLR with Glasgow Coma Scale(GCS) scores of patients,the 1-week,6-month mortality and 6-month unfavorable outcome(GCS 1-3) were analyzed.Results NLR was significantly higher in trauma group than that in control group(P<0.01).NLR was negatively associated with(GCS) scores of STBI patients(r=-5.120,P<0.01).NLR was an independent risk factor for 1-week mortality(OR=2.051,95%CI:1.051-4.005),6-month mortality(OR=2.047,95%CI:1.233-3.397) and 6-month unfavorable outcome(OR=2.113,95%CI:1.329-3.360).The areas under receiver operating characteristic curve(AUC) of NLR for predicting 1-week mortality,6-month mortality and 6-month unfavorable outcome were 0.807(95%CI:0.727~0.871),0.813(95%CI:0.734~0.877) and 0.804(95%CI:0.724-0.869),respectively.There was no significant difference in prognostic predictive value of STBI between GCS scores and NLR(P >0.05).Conclusion NLR is significantly elevated in STBI patients and has negative associationwith GCS scores at trauma.NLR is closely correlated with short-term mortality and unfavorable outcome and has clinical prognostic value.更多还原