The Relationship Between The Ratio Of Neutrophil To Lymphocyte And The Poor Prognosis Of Hypertensive Intracerebral Hemorrhage 90 Days After Operation

Objective: Inflammation after hypertensive intracerebral hemorrhage is an important part of the brain injury.Inflammation is caused by hematoma components.The ratio of neutrophil to lymphocyte is a new composite inflammatory marker for predicting the prognosis of intracranial hemorrhage.The purpose of this study was to investigate the relationship between the laboratory examination data such as white blood cell count,neutrophil count,lymphocyte count,monocyte count,neutrophil to lymphocyte ratio,brain CT imaging data and other clinical data on 90-day poor prognosis of patients with hypertensive intracerebral hemorrhage treated by neurosurgery.Methods: A total of 168 patients with acute hypertensive intracerebral hemorrhage who were admitted to Affiliated Zhongshan Hospital Dalian University from October2016 to October 2018 were retrospectively studied.According to the 90-day follow-up(outpatient or telephone)results,the prognostic function was assessed by Glasgow Prognostic Score.They were divided into 2 groups.The glasgow outcome scale﹥3was defined as the group with good prognosis(control group).A total of 72 patients were included in this group.The glasgow outcome scale ≦ 3(including death,vegetative or severe disability)was considered as the group with the poor prognosis(experimental group).A total of 96 patients were included in this group.The clinical data of the two groups was extracted from the electronic medical records of the hospital.By comparing the differences between the twogroups,binary logistic regression analysis was performed on the variables of significance of single factor analysis to determine the independent risk factors of poor prognosis in 90 days.The predictive ability of each independent risk factor was evaluated by the Receiver Operational Characteristic Curve analysis method.Spearman correlation analysis was used to analyze the independent risk factors affecting the ratio of neutrophils to lymphocytes.Result: The analysis of the two groups showed that.Univariate analysis showed that patients with poor prognosis after 3 months showed lower Glasgow coma score,larger hematoma volume,higher ratio of neutrophils to lymphocytes,higher white blood cell count,higher neutrophil count,higher monocyte count.In addition,these patients also had a subarachnoid hemorrhage,intraventricular hemorrhage,Hydrocephalus.Further binary logistic regression analysis showed that only Glasgow coma score at admission,hematoma volume,and the ratio of neutrophils to lymphocytes at admission was independent risk factors for poor prognosis after 3 months of hypertensive intracerebral hemorrhage.Spearman regression analysis showed that the ratio of neutrophil to lymphocyte at admission was significantly correlated with Glasgow coma score,hematoma volume,subarachnoid hemorrhage,intraventricular hemorrhage,white blood cell count,neutrophil count,lymphocyte count and grouping.Conclusion: Lower Glasgow coma score,larger hematoma volume and a higher ratio of neutrophil to lymphocyte in admission are independent risk factors for poor prognosis of patients with hypertensive intracerebral hemorrhage at 3 months after operation.Through the analysis of the receiver operating characteristic curve,when the ratio of neutrophil to lymphocyte ≧8.85,hematomas volume ≧46.29 ml,and Glasgow coma score ≦8 points in patients with hypertensive cerebral hemorrhage,the prognosis can be predicted;the ratio of neutrophils to lymphocytes were significantly associated with Glasgow coma score,hematoma volume,subarachnoid hemorrhage,intraventricular hemorrhage,neutrophil count,lymphocyte count,white blood cell count,and a lower 3 month post Glasgow outcome score.