HRR、PLR与中重度颅脑损伤患者短期死亡的关系研究

摘要 目的：探讨血红蛋白/红细胞分布宽度比值（HRR）、血小板/淋巴细胞比值（PLR）与中重度颅脑损伤（TBI）患者短期死亡的关系。方法：回顾性收集2019年9月～2021年9月徐州医科大学附属医院收治的162例中重度TBI患者的病历资料，根据患者入院30d内生存状态分为死亡组和存活组。计算HRR和PLR，采用多因素Logistic回归分析中重度TBI患者短期死亡的影响因素，受试者工作特征（ROC）曲线分析格拉斯哥昏迷量表（GCS）评分联合HRR、PLR对中重度TBI患者短期死亡的预测价值。结果：162例中重度TBI患者入院30 d内死亡率为35.80%（58/162）。与存活组比较，死亡组HRR降低，PLR升高（P＜0.05）。多因素Logistic回归分析显示，GCS评分＜9分、瞳孔散大、脑疝和HRR降低、PLR升高为中重度TBI患者短期死亡的独立危险因素（P＜0.05）。ROC曲线分析显示，HRR、PLR联合GCS评分预测中重度TBI患者短期死亡的曲线下面积最大，为0.924。结论：HRR降低和PLR升高与中重度TBI患者短期死亡相关，可能成为中重度TBI患者短期死亡的辅助预测指标，在GCS评分基础上联合HRR、PLR能提升对中重度TBI患者短期死亡的预测价值。

Study on the Relationship between HRR, PLR and Short-term Mortality of Patients with Moderate to Severe Traumatic Brain Injury

ABSTRACT Objective: To explore the relationship between hemoglobin to red blood cell distribution width ratio (HRR), platelet to lymphocyte ratio (PLR), and short-term mortality of patients with moderate to severe traumatic brain injury (TBI). Methods: The medical records of 162 patients with moderate to severe TBI who were admitted to Xuzhou Medical University Affiliated Hospital from September 2019 to September 2021 were retrospectively collected, and the patients were divided into death group and survival group based on their survival status within 30d of admission. The HRR and PLR were calculated, the influencing factors of short-term mortality of patients with moderate to severe TBI was analysed by multivariate Logistic regression, and the predictive value of the Glasgow Coma Scale (GCS) scores combined with HRR and PLR for short-term mortality of patients with moderate to severe TBI was analysed by the receiver operating characteristic (ROC) curve. Results: The mortality rate of 162 patients with moderate to severe TBI within 30 d of admission was 35.80% (58/162). Compared with the survival group, the HRR decreased and PLR increased of the death group (P<0.05). The multivariate Logistic regression analysis showed that GCS scores less than 9 scores, dilated pupils, brain hernia, HRR decreased and PLR increased were independent risk factors for short-term mortality of patients with moderate to severe TBI (P<0.05). The ROC curve analysis showed that the area under the curve for predicted short-term mortality of patients with moderate to severe TBI by HRR and PLR combined with GCS scores was the largest, which was 0.924. Conclusion: HRR decrease and PLR increase are associated with short-term mortality of patients with moderate to severe TBI, which may become an auxiliary predictor of short-term mortality of patients with moderate to severe TBI, combining with HRR and PLR on the basis of GCS scores can enhance the predictive value of short-term mortality of patients with moderate to severe TBI.