Relationship between indicators related to systemic inflammatory response and severity of intracerebral hemorrhage and their predictive value for prognosis
Objective To investigate the relationship of peripheral blood white blood cell count(WBC),neutrophil count(ANC),lymphocyte count(ALC),CD3+,CD4+,CD8+T-lymphocyte counts,as well as tumor necrosis factor-alpha(TNF-alpha),C-reactive protein(CRP),interleukin-6(IL-6),transforming growth factor-beta 1(TGF-β1)and the severity of acute intracerebral hemorrhage(ICH).To explore their predictive value for prognosis.Methods Sixty-five patients with spontaneous ICH who were admitted to Department of Neurosurgery,Guanyun People's Hospital from January 2020 to June 2021 were selected as the observation group,and 27 healthy people who underwent physical examination during the same period were selected as the control group.The percentages of various types of lymphocytes in peripheral blood and the levels of related inflammatory factors(TNF-α,CRP,IL-6,TGF-β1)in serum were detected,and their dynamic change trends and their correlation with the severity of ICH were analyzed.The Cox proportional hazard model and receiver operating characteristic(ROC)curve were used to analyze the predictive performance of inflammatory response-related indicators on the prognosis of patients with ICH.Results WBC,ALC,and CD3+lymphocytes were significantly decreased in medium and heavy patients compared with the control group.The serum levels of each immune factor in light,medium and severe patients were elevated in CRP,TNF-α,and IL-6,and decreased in TGF-β1,compared with the regular group.In patients on days 1,3,and 7 after hemorrhage,WBC,ALC,CRP,TNF-α,and IL-6 WBC,ALC,CRP,TNF-α and IL-6 were increased,while CD3+,CD4+T lymphocytes,CD4+/CD8+ratio and TGF-β1 were decreased in patients with ICH.On the 14th day,the WBC and ALC levels in patients with ICH were significantly higher than those in the control group.In the group with no improvement in ICH,the WBC,ALC,CRP,TNF-α and IL-6 were increased.CD3+,CD4+T lymphocytes,while CD4+/CD8+ratio and TGF-β1 were decreased.The levels of WBC,ALC,TNF-α,and IL-6 increased in patients in the improvement group,while the levels of CD3+and TGF-β1 decreased.The net benefit of the CD3+,CD4+,and CD8+DCA composite analysis model was better than that of the other three models,and the time-dependent area under curve(AUC)analysis demonstrated that the predictive performance of WBC was optimal,and that WBC,ALC,CRP,and TNF-α as prognostic risk factors.Conclusions WBC,ALC,CRP,IL-6 and TNF-α were significantly elevated in patients with ICH and positively correlated with the severity of the disease,which can be used as an essential indicator for determining the severity of the disease.WBC is more important in predicting the prognosis of patients with ICH.
intracerebral hemorrhagesystemic inflammatory responsepredictive value
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