| Objective: This study aims to through the clinical observation indexes and late-onset cerebral ischemia after aneurysmal subarachnoid hemorrhage and prognosis were retrospectively analyzed,out of late-onset risk factors and prognosis of cerebral ischemia,in order to realize the early assessment of the patient condition,explore the number of neutrophils and lymphocytes count ratio can be as an effective biological indicators,predict whether late-onset cerebral ischemia occurs,early prevention and control,in order to achieve the purpose of improving the prognosis of patients.Methods: On January 1,2015 to December 31,2018 for aneurysmal subarachnoid hemorrhage in hospital,hospital of interventional embolization procedure,and met inclusion and exclusion criteria of patients as the research object,and on the basis of whether the late-onset cerebral ischemia group: occur late-onset cerebral ischemia group,did not occur late-onset cerebral ischemia group,according to the different prognosis grouping: Good prognosis group(GOS score 1 to 3points)and with poor prognosis group(GOS score 4 ~ 5 points),analysis of age,gender,nationality,white blood cell count,neutrophil count,blood sugar,blood fat,all kinds of clinical grading,complications such as of late and prognosis of cerebral ischemia,discusses on admission number of neutrophils and lymphocytes count ratio can be as effective biomarkers to predict the occurrence of late-onset cerebral ischemia,and applying subjects working curve to find the number of neutrophils and lymphocytes count ratio to predict the best cutoff values occur late-onset cerebral ischemia.Results:1.General situation: a total of 73 patients met the inclusion and exclusion criteria,and there was no significant difference in age,gender,ethnicity,previous medical history(hypertension,diabetes,heart disease),or bad living habits(smoking history,drinking history)in different groups(P>0.05).2.Analysis of related factors affecting delayed cerebral ischemia:Number of neutrophil,lymphocyte count,GCS score,neutrophils ratio and lymphocyte count,prothrombin time(PT)and whether delayed cerebral hemorrhage correlation(P < 0.05),and the number of neutrophils and lymphocytes number ratio,GCS score is late-onset independent risk factors for cerebral ischemia(OR = 1.628,P = 0.001),through the receiver-operating characteristic curve(ROC curve)can be learned that the number of neutrophils and lymphocytes count ratio to predict whether the best cutoff value is 14.98 late-onset cerebral ischemia(area under the curve is 0.959,P=0.000,sensitivity 91.7%,specificity 90.20%).3.Analysis of relevant factors affecting the prognosis of patients: GCS score,WFNS score,hemorrhage into ventricle,rehemorrhage,and serum sodium were correlated with the prognosis of patients at admission(P<0.05),and rehemorrhage and serum sodium were independent risk factors for poor prognosis of patients(P<0.05).Conclusion: Number of neutrophils and lymphocytes count ratio can be used as predicting whether the aneurysmal subarachnoid hemorrhage patients occur late-onset biological markers of cerebral ischemia,when patients admitted to hospital neutrophils and lymphocytes number ratio > 14.98,which should be paid attention during clinical physicians,adopt the dynamic monitoring of the cerebral blood flow,cerebral oxygen and monitoring,monitoring methods,such as intracranial pressure monitoring,evaluation of patients with brain blood supply,early intervention treatment,prevention and treatment of delayed cerebral ischemia.The severity of the patient’s condition at the time of admission is closely related to the prognosis,and the occurrence of complications will increase the mortality rate of the patient and seriously affect the prognosis of the patient.Therefore,active and effective treatment methods should be adopted in clinical work to prevent and treat the possible complications after the rupture of cerebral aneurysm,so as to improve the prognosis of the patient. |
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