NLR、PLR、LMR等炎症标志物与原发性脑干出血患者预后的相关性研究

Association of the inflammatory markers neutrophil-to-lymphocyte ratio, platelet-to-lymphocyte ratio, and lymphocyte-to-monocyte ratio with the prognosis of patients with primary brainstem hemorrhage

摘要:

目的 探讨中性粒细胞-淋巴细胞比值（NLR）、血小板-淋巴细胞比值（PLR）和淋巴细胞-单核细胞比值（LMR）等炎症标志物与原发性脑干出血（PBH）患者预后的相关性，为临床预后评估提供新的指标。方法 回顾性分析2022年1月—2024年12月贵阳市第二人民医院收治的177例PBH患者临床资料，包括人口学特征、血常规指标、影像学表现、治疗方式及3个月随访结果。计算NLR、PLR和LMR，采用格拉斯哥预后评分（GOS）评估预后，分为预后良好组（GOS 4~5分）和预后不良组（GOS 1~3分）。通过Logistic回归分析探讨炎症标志物与预后的相关性。结果 177例患者中，预后良好83例（46.9%），预后不良94例（53.1%）。多因素Logistic回归分析表明，NLR是PBH预后不良的危险因素（OR=14.724, 95%CI: 5.164~41.981, P<0.001），入院GCS（OR=0.688, 95%CI: 0.605~0.782, P<0.001）和机器人辅助手术（OR=0.007, 95%CI: 0.001~0.094, P<0.001）是保护性因素。结论 NLR是PBH患者预后不良的危险因素。机器人辅助手术可能通过减少炎症反应来改善预后。

Abstract:

Objective To investigate the association of neutrophil-to-lymphocyte ratio （NLR）， platelet-to-lymphocyte ratio （PLR）， and lymphocyte-to-monocyte ratio （LMR） with the prognosis of patients with primary brainstem hemorrhage （PBH）， and to provide new indicators for clinical prognostic evaluation.Methods A retrospective analysis was performed for the clinical data of 177 PBH patients who were admitted to The Second People’s Hospital of Guiyang from January 2022 to December 2024， including demographic features， routine blood test results， imaging findings， treatment modalities， and 3-month follow-up outcomes. NLR， PLR， and LMR were calculated， and the Glasgow Outcome Scale （GOS） was used to assess prognosis. The patients were divided into good prognosis group （with a GOS score of 4-5） and poor prognosis group （with a GOS score of 1-3）. Univariate analysis and multivariable logistic regression analysis were used to investigate the association between inflammatory markers and prognosis.Results Among the 177 patients， 83 （46.9%） had a good prognosis， and 94 （53.1%） had a poor prognosis. The multivariable logistic regression analysis showed that NLR was a risk factor for poor prognosis in PBH （odds ratio ［OR］ = 14.724， 95% confidence interval ［CI］： 5.164-41.981， P <0.001）， while GCS score on admission （OR = 0.688， 95% CI： 0.605-0.782， P <0.001） and robot-assisted surgery （OR = 0.007， 95% CI： 0.001-0.094， P <0.001） were protective factors.Conclusion NLR is closely associated with the prognosis of PBH and is a risk factor for poor prognosis. Robot-assisted surgery can improve prognosis by reducing inflammatory response.