The Relationship Between The Ratio Of Neutrophil And Lymphocytde And The Edema Zone Around Hematoma After Hypertensive Cerebral Hemorrhage And The Prognosis Of Patients

Objective: This research analyzed the relationship between NLR of patients with hypertensive intracerebral hemorrhage(HICH)treated conservatively and surgically at the 6th hour,the first day,the 7th day,the 14 th day,and brain edema volume.The relationship between NLR and short-term prognosis of patients,so as to summarize the experience and find out the relationship between inflammation reaction and brain edema after intracerebral hemorrhage,hoping to benefit patients.Methods: We adopted retrospective research,and we collected 115 patients with hypertensive intracerebral hemorrhage from Neurosurgery Department of my Hospital from January 2017 to October 2018.Among them,79 patients were in conservative group and 36 patients were in surgical group.We collected characteristics of all these patients with hypertensive intracerebral hemorrhage(including sex,age,past medical history,medication history,smoking history,drinking history,etc.),Glasgow Coma Scale(GCS)at admission and modified RanKIN scale(MRS)at one month after onset were analyzed.The relationship between conservative group and surgical group at the 6th hour,the first day,the third day,the 7th day and the 14 th day,and brain edema volume and NLR,and the predictive analysis of NLR and the short-term adverse prognosis of patients.Results: Among 115 patients with hypertensive cerebral hemorrhage,79 were in conservative group and 36 were in surgical group.(1)There was no significant difference between the two groups in gender,age,past medical history,medication history,smoking history and drinking history(P > 0.05);(2)There was no significant difference in GCS score between the two groups in admission(p > 0.05);(3)NLR was positively correlated with the volume of brain edema at 6hours and 1day after onset(p < 0.05),and they had a wireless correlationon the third day,the 7th day and the 14 th day after onset(p > 0.05);(4)There were differences in NLR between post-poor and good prognosis.Post-poor and good prognosis had differences at the 6th hour,the first day and the seventh day.The NLR in poor prognosis group was higher than that of good prognosis group(p < 0.05);(5)AUC of poor prognosis in conservative group was 0.625,sensitivity was 53.1%,specificity was 86.7%,and the best cut-off value of NLR was 8.75;(6)AUC of poor prognosis in operation group was 0.833 on the 14 th day after onset.The sensitivity was 70.0%,specificity was 87.5%,and the best truncation value of NLR was 5.15;(7)AUC was0.6545,sensitivity was 58.0%,specificity was 73.9%,and the best truncation value of NLR was 6.25;(8)NLR had statistical significance for poor prognosis(p < 0.05),and NLR 7 d > 6.25 was 3.908 times higher than NLR 7 d < 6.25.Conclusion :(1)NLR is positively correlated with the volume of cerebral edema in patients with hypertensive intracerebral hemorrhage the 6th hour and the first day after onset.(2)NLR is not significantly correlated with the volume of cerebral edema in patients with hypertensive cerebral hemorrhage on the third day,the 7th day and 14 th day after onset.(3)Within 1 day after onset,NLR in patients with poor prognosis is higher than that in patients with good prognosis(4)NLR is an independent predictor of the adverse prognosis of hypertensive cerebral hemorrhage.If NLR > 6.25,the risk of adverse prognosis is greatly increased.Whether conservative treatment or conical craniotomy,NLR > 6.25 is 3.908 times higher than NLR < 6.25.