Correlation Analysis Of Neutrophil-lymphocyte Ratio And Prognosis In Elderly Patients With Hypertensive Intracerebral Hemorrhage

ObjectiveBy collecting the neutrophil/lymphocyte radio（NLR）ratio at admission and the prognosis at discharge of elderly patients with hypertensive intracerebral hemorrhage,we want to explore the correlation between early NLR level and prognosis of elderly hypertensive intracerebral hemorrhage.It provides a new idea for early judgment of the clinical outcome of hypertensive intracerebral hemorrhage,and a new theoretical basis for clinical management of improving the prognosis of patients.MethodsThis study selected elderly Hypertensive Intracerebral Hemorrhage（HICH）inpatients aged 60 and above who were admitted to Neurosurgery Department of the Second Affiliated Hospital of Shenyang Medical College from September 2020 to December 2021 as the disease group,a total of 106 cases,and their disease diagnosis match the Chinese Multidisciplinary Guidelines for Diagnosis and Treatment.We also need to count their general information,including age,gender,smoking history,drinking history,diabetes history,in these data,smoking history is more than 1cigarette per day for half a year;the diagnosis of diabetes conforms to the Chinese Guidelines for the Prevention and Treatment of Type 2 Diabetes（2020 Edition）.The selected patients need to collect venous blood within 24 hours of onset,and count the absolute value of neutrophil（NEUT）,lymphocyte（LYMPH）and NLR.The modified Rankin Scale（m RS）was used to evaluate the condition of the patients at discharge and grouped them into groups.The m RS3-6 score was regarded as the poor prognosis group（death was classified into the poor prognosis group）,with a total of 46 cases,and the m RS0-2 score was regarded as the good prognosis group,with a total of 60 cases.A total of 50 people over 60 years old only with a clear history of hypertension were selected as the control group to collect venous blood from the Physical Examination Department and Cardiovascular Medicine Department of the Second Affiliated Hospital of Shenyang Medical College.Another 50 healthy people who underwent regular physical examinations in the Physical Examination Department of the Second Affiliated Hospital of Shenyang Medical College were selected as an additional control group,and venous blood was collected at the same time,which to exclude the effect of hypertension on NLR.SPSS23.0 statistical software was used to analyze the data,and to review whether the difference in NLR between the two groups of patients was statistically significant at admission.At the same time,it was also used to analyze whether there is a statistically significant difference in NLR data between the control group and the additional control group;After excluding the influence of hypertension,the NLR difference between the two groups and the control group was analyzed for significance;finally,the predictive ability of various factors in the patient group to predict the prognosis of the disease was analyzed.The t test was used for data conforming to normal distribution,nonparametric test was used for data that did not conform to normal distribution;The correlation between the two variables is compared using Person correlation analysis;and χ2 test was used for dichotomous variables;using Receiver Operating Characteristic curves to assess the value of influencing factors;multivariate analysis using logistic regression,according to the Youden index to determine the critical value.Results1.The value of NLR in early venous blood of elderly HICH patients is related to the prognosis of patients.（P=0.034）The higher the NLR,the greater the possibility of poor prognosis.2.There was no statistical significance in the general data comparison between the good prognosis group and the poor prognosis group（P>0.05）.3.The NLR of the diseased group was higher than that of the control group at admission;compared with the good prognosis group,the difference between the NLR of the poor prognosis group and the control group was more significant（Good prognosis group,P=0.013;poor prognosis group,P<0.01）.4.Lymphocyte counts and NLR at admission in elderly HICH patients have moderate predictive effects on their prognosis,while neutrophil counts have poor predictive effects,and NLR had the best predictive effect（NLR,AUC=0.728;lymphocyte count,AUC=0.704;neutrophil count,AUC=0.678）.The CUT-OFF predicted by NLR was4.635,the sensitivity was 66.7%,and the specificity was 73.9%.5.Early NLR can be used as an independent predictor for predicting the prognosis of elderly HICH（OR=1.317,95%CI=1.027-1.690,P=0.030）.ConclusionIn this study,through the study of the relationship between the early NLR value and the prognosis of elderly HICH patients,it was found that the NLR of HICH patients was higher than that of the general population,and the effect of NLR in predicting the prognosis of patients was very satisfactory.The higher the NLR at the time of admission,the greater the risk of poor prognosis,which makes an important reference for us to timely intervene with relevant measures and even consider surgical indications.Compared with traditionally used NEUT and LYMPH,NLR has the best prognostic prediction ability.The increase of NLR is an independent risk factor for poor prognosis of patients.Specifically,for each unit increase of NLR,the risk of poor prognosis may increase by 31.7%.High NLR suggests that we should focus on monitoring the changes of patients’ condition,improve diagnosis and treatment and nursing methods,and take necessary clinical measures to delay the occurrence and change of inflammatory response as much as possible,so as to reduce the probability of adverse outcomes in young and elderly HICH patients as much as possible.