神经病学与神经康复学杂志2025，Vol.21Issue(2)：114-122,9.DOI:10.12022/jnnr.2024-0245
NLR联合血肿影像学特征预测基底节区脑出血后迟发性血肿周围脑水肿
Prediction of delayed perihematoma cerebral edema after basal ganglia hemorrhage based on neutrophil-to-lymphocyte ratio combined with imaging features of hematoma
摘要
Abstract
Objective:To investigate the predictive value of neutrophil to lymphocyte ratio(NLR)combined with hematoma imaging features for delayed perihematoma edema(dPHE)after spontaneous basal ganglia hemorrhage. Methods:Retrospective inclusion of patients with spontaneous basal ganglia hemorrhage admitted to the neurology department of Jinhua Hospital affiliated to Zhejiang University School of Medicine(Jinhua Municipal Central Hospital)from January 2017 to December 2023.We compared clinical data between the dPHE group and no-dPHE group based on the univariate analysis and multivariate binary logistic regression analysis.We identified the independent influencing factors of dPHE,and evaluated the predictive value of the model for dPHE using receiver operating characteristic(ROC). Results:A total of 372 patients were included in this study,including 115 in the dPHE group and 257 in the no-dPHE group.Univariate analysis showed that the baseline National Institutes of Health Stroke Scale(NIHSS)score,baseline hematoma volume,high-sensitivity C-reactive protein,lymphocyte count,NLR,blend sign,lateral hematoma,and high-dose mannitol proportion in the dPHE group were significantly higher than those in the non-dPHE group(P＜0.05).Moreover,the NIHSS score and hospitalization expenses in the dPHE group were higher than those in the no-dPHE group(P＜0.05),and their hospitalization time was also longer in the dPHE group(P＜0.05).Furthermore,the multivariate logistic regression analysis revealed that NLR[odds ratio(OR)=1.138(95％CI:1.056-1.227);P=0.001],baseline hematoma volume[OR=1.187(95％CI:1.132-1.246);P＜0.001]and lateral hematoma[OR=3.067(95％CI:1.611-5.838);P=0.001]were independent predictive factors of dPHE.ROC analysis showed that the area under the curve of the model was 0.810(95％CI:0.765-0.856). Conclusion:The higher the baseline NLR,the larger the hematoma volume,and patients with lateral basal ganglia hemorrhage are more susceptible to dPHE.关键词
基底节区脑出血/迟发性血肿周围脑水肿/中性粒细胞/淋巴细胞比值Key words
Basal ganglia hemorrhage/Delayed perihematoma cerebral edema/Neutrophil to lymphocyte ratio引用本文复制引用
潘小玲,张美霞,胡传琛,姚余,陈红芳..NLR联合血肿影像学特征预测基底节区脑出血后迟发性血肿周围脑水肿[J].神经病学与神经康复学杂志,2025,21(2):114-122,9.基金项目
金华市科技局重点项目(2021-3-076)Key Project of Jinhua Science and Technology Bureau(2021-3-076) （2021-3-076）
