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| 高血压脑出血术后外周血单核细胞计数与近期预后关系 |
| Association of peripheral monocyte count and recent prognosis after surgery of hypertensive intracerebral hemorrhage |
| 投稿时间：2015-11-02 |
| DOI：10.3969/j.issn.1000-0399.2016.05.010 |
| 中文关键词: 高血压脑出血 白细胞 中性粒细胞 单核细胞 预后 |
| 英文关键词: Hypertensive intracerebral hemorrhage White blood cell Neutrophil Monocyte Prognosis |
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| 中文摘要: |
| 目的 探究单核细胞与高血压脑出血术后30 d病死率之间的关系。方法 回顾性分析2012年1月至2014年3月安徽医科大学第一附属医院和安徽医科大学附属巢湖医院,通过手术治疗的高血压脑出血患者341例临床资料。所有患者从发病至手术的时间均在12 h以内,收集其性别、年龄、GCS、血肿体积、血肿部位、血红蛋白含量、总白细胞计数、中性粒细胞绝对计数和单核细胞绝对计数等。运用线性回归分析外周血细胞计数与血肿体积的关系;二元logistic回归分析相关因素与术后30 d病死率之间的关系。结果 341例患者中;基底节出血209例,脑叶出血132例,其中出血破入脑室99例;出血量40~95 mL,平均(60.68±12.46)mL;入院时格拉斯哥昏迷评分(GCS评分)6~15分。入院时白细胞计数以及中性粒细胞计数与血肿体积呈线性关系,而单核细胞数与血肿体积无关。与术前相比,术后外周血白细胞、中性粒细胞和单核细胞的数量持续升高,在术后3 d左右达到峰值,7 d左右降至正常水平。回归分析发现术后外周血单核细胞数与30 d病死率密切相关(OR=6.27,95% CI:1.07~36.89,P=0.04)。结论 高血压脑出血患者术后炎症反应仍然持续存在,单核细胞计数升高是患者30 d病死率的危险因素之一,干预单核细胞致伤途径可能成为高血压脑出血术后治疗方法之一。 |
| 英文摘要: |
| Objective To explore the relationship between monocyte count and 30-day mortality after surgery of hypertensive intracerebral hemorrhage(HICH), so as to identify monocyte as one of the pathogenic factors of second brain damage after HICH. Methods The medical records of patients underwent HICH operation in two hospitals(The First Affiliated Hospital of Anhui Medical University, The Affiliated Chaohu Hospital of Anhui Medical University) from Jan 2012 to Mar 2014 were retrospectively analyzed. All patients had surgery within 12 hours of disease onset. Other clinical factors of the patients including sex, age, GCS, volume of hematoma, location, initial hemoglobin, total white blood cell(WBC) count, absolute neutrophil count(ANC), absolute monocyte count(AMC) were collected. The association between the peripheral blood cell count and the volume of hematoma was analyzed with linear regression analysis, and the association between those clinical factors and the postoperative 30-day mortality was analyzed with binary logistic regression analysis. Results In the 341 cases of HICH patients enrolled, there were 176 males and 165 females, with an average age of(52.0±7.9) years old, and 209 cases of hemorrhage in the basal ganglia and 132 cases in the brain lobe, in which 99 cases combined with intra-ventricular hemorrhage. The volume of hemorrhage was 40~95 ml, an average of(60.68±12.46) ml. The Glasgow coma scores(GCS) on admission of all patients were 6~15. The peripheral WBC and ANC on admission had a linear relation with the volume of hemorrhage, but the peripheral AMC hadn't. The postoperative peripheral WBC, ANC and AMC increased sustainedly and reach the peak at 3 days, then decreased to normal level at 7 days after operation. Regression analysis showed that the postoperative peripheral AMC was closely associated with the 30-day mortality(OR=6.27, 95% CI 1.07-36.89, P=0.04). Conclusion Inflammation reaction would persist after surgery of HICH, and elevation of the peripheral AMC after operation might be a risk factor of 30-day mortality in HICH patients. To intervene the monocyte-mediated inflammatory pathways may be an effective target for the treatment of patients after surgery of HICH. |
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