【原】中性粒细胞/淋巴细胞计数比值可预测重型颅脑损伤患者的死亡率

    本公众号每天分享一篇最新一期Anesthesia & Analgesia等SCI杂志的摘要翻译，敬请关注并提出宝贵意见     

The Neutrophil/Lymphocyte Count Ratio Predicts Mortality in Severe Traumatic Brain Injury Patients

背景与目的

中性粒细胞-淋巴细胞计数比（NLCR）是一种简单的、低成本炎症反应指标。NLCR已被证明是炎性相关组织损伤临床严重程度的敏感标记，而在创伤性颅脑损伤(TBI)患者中，NLCR的高值与其预后不良相关。本研究的目的是回顾性分析NLCR以及其与脑损伤类型相关的TBI患者队列预后的关系。

方  法

本研究纳入格拉斯哥昏迷评分低于8分的孤立性TBI成年患者。NLCR的计算方法为入院后立即评估和进入重症监护病房(ICU)后连续6天评估绝对中性粒细胞与淋巴细胞计数之间的比值。根据入院时计算机断层扫描(CT)的神经影像学表现对脑损伤进行分类：DAI——严重弥漫性轴索损伤患者；CE——大脑半球或局灶性脑水肿患者；ICH——脑出血患者；S-EH/SAH——硬膜下和/或硬膜外血肿/蛛网膜下腔出血患者。

结  果

本研究对144例患者的NLCR进行了计算。死亡组入院时的NLCR显著高于入院后28天存活组入院时的NLCR (p < 0.05)。持续较高NLCR值与预后不良相关，而入院时NLCR高于15.63是28天死亡率的预测因子。与其他颅脑损伤患者相比，DAI组患者入院时NLCR值最高(p < 0.001)。

结  论

NLCR可作为预测TBI患者预后的有效指标。需要进一步的研究来证实这些结果。

原始文献摘要

Siwicka-Gieroba D, Malodobry K, Biernawska J, et al.The Neutrophil/Lymphocyte Count Ratio Predicts Mortality in Severe Traumatic Brain Injury Patients[J]. J Clin Med,2019,8(9):pii: jcm8091453.

Introduction: Neutrophil-lymphocyte count ratio (NLCR) is a simple and low-cost marker of inflammatory response. NLCR has shown to be a sensitive marker of clinical severity in inflammatory-related tissue injury, and high value of NLCR is associated with poor outcome in traumatic brain injured (TBI) patients. The purpose of this study was to retrospectively analyze NLCR and its association with outcome in a cohort of TBI patients in relation to the type of brain injury.

Methods: Adult patients admitted for isolated TBI with Glasgow Coma Score lower than eight were included in the study. NLCR was calculated as the ratio between the absolute neutrophil and lymphocyte count immediately after admission to the hospital, and for six consecutive days after admission to the intensive care unit (ICU). Brain injuries were classified according to neuroradiological findings at the admission computed tomography (CT) as DAI—patients with severe diffuse axonal injury; CE—patients with hemispheric or focal cerebral edema; ICH—patients with intracerebral hemorrhage; S-EH/SAH—patients with subdural and/or epidural hematoma/subarachnoid hemorrhage.

Results: NLCR was calculated in 144 atients. Admission NLCR was significantly higher in the non-survivors than in those who survived at 28 days (p < 0.05) from admission. Persisting high NLCR value was associated with poor outcome, and admission NLCR higher than 15.63 was a predictor of 28-day mortality. The highest NLCR value at admission was observed in patients with DAI compared with other brain injuries (p < 0.001).

Concussions: NLCR can be a useful marker for predicting outcome in TBI patients. Further studies are warranted to confirm these results.

罂粟花

麻醉学文献进展分享

贵州医科大学高鸿教授课题组

翻译：冯玉蓉    编辑：何幼芹   审校：王贵龙