中性粒细胞-淋巴细胞比值在颅脑损伤预后评估中的作用

目的 探讨中性粒细胞-淋巴细胞比值（NLR）在颅脑损伤（TBI）预后评估中的作用。方法 回顾性分析2015年3月~2019年1月收治的105例TBI的临床资料。伤后6个月，采用GOS评分评估预后，1~3分为预后不良，4~5分为预后良好。采用多因素logistic回归分析检验预后不良危险因素，采用受试者工作特征（ROC）曲线分析NLR对TBI病人6个月预后的预判价值。结果 105例中，预后不良34例，发生率为32.38%。多因素logistic回归分析结果显示，入院时GCS评分≤8分、颅内压增高、瞳孔对光反射消失和NLR均是TBI病人伤后6个月预后不良的独立危险因素（P<0.05）。ROC曲线分析结果显示NLR的最佳临界值为4.12，此时灵敏度为85.7%，特异度为81.6%，当NLR≥4.12时，TBI病人预后不良的发生率高达93.6%。结论 入院时NLR水平可作为预测TBI伤后6个月预后不良的参考指标，可早期、迅速、准确判断病人预后，及时有效地采取干预措施，改善病人预后

Role of neutrophil-lymphocyte ratio in prognostic evaluation of traumatic brain injury

Objective To investigate the role of neutrophil-lymphocyte ratio (NLR) in the prognostic evaluation of traumatic brain injury (TBI). Methods The clinical data of 105 patients with TBI who were admitted to our hospital from March 2015 to January 2019 were retrospectively analyzed. At 6 months after injury, GOS score was used to evaluate the prognosis, with a poor prognosis of GOS score 1~3, and a good prognosis of GOS score 4~5. Multivariate logistic regression analysis was used to test the risk factors for poor prognosis, and receiver operating characteristic (ROC) curve was used to analyze the prognostic value of NLR for evaluating the prognosis of TBI patients. Results Of 105 patients, 34 patients (32.38%) had poor prognosis, and 71 had good prognosis. Multivariate logistic regression analysis showed that GCS score ≤8 on admission, intracranial hypertension, disappearance of pupillary light reflection and NLR were independent risk factors for poor prognosis of TBI patients at 6 months after injury (P<0.05). The results of ROC curve analysis showed that the optimal cut-off value of NLR was 4.12, with a sensitivity of 85.7% and a specificity of 81.6%. When NLR ≥ 4.12, the incidence of poor prognosis in TBI patients was as high as 93.6%. Conclusions The level of NLR at admission can be used as an indicator for predicting poor prognosis 6 months after TBI, which can evaluate the prognosis of TBI patients early, quickly and accurately, and then take effective measures to improve the prognosis of TBI patients