高血压脑出血患者外周血SII、NLR变化及与颅内压的关系

Changes of SII and NLR in Peripheral Blood and Their Relationship with Intracranial Pressure in Patients with Hypertensive Cerebral Hemorrhage

摘要: 目的：探究高血压脑出血患者外周血系统性免疫炎症指数(SII)、中性粒细胞–淋巴细胞比值(NLR)变化及与颅内压(ICP)的关系。方法：回顾性分析2023年10月~2025年2月我院神经外科收治的120例高血压脑出血患者的临床资料，根据治疗方式的不同分为开颅组(开颅治疗患者，n = 40)和保守组(保守治疗患者，n = 80)。比较两组患者发病后48 h、72 h、120 h的ICP和血常规指标SII、NLR变化情况，分析高血压脑出血患者外周血SII、NLR与ICP的关系。结果：发病后48 h、72 h、120 h，两组ICP、SII、NLR水平均呈降低趋势(P < 0.05)，且开颅组ICP、SII、NLR明显高于保守组(P < 0.05)。保守组、开颅组患者外周血SII、NLR水平与其ICP均呈正相关(P < 0.05)。结论：高血压脑出血患者外周血SII、NLR水平在发病48 h后呈逐渐降低趋势，且与患者ICP呈动态正相关，开颅治疗会加深其相关程度，临床治疗中可将外周血SII、NLR作为预测高ICP风险的细胞学标志物，为临床医生及时治疗提供有利信息参考。

Abstract: Objective: To investigate the changes of systemic immune inflammatory index (SII), neutrophil-lymphocyte ratio (NLR) and their relationship with intracranial pressure (ICP) in patients with hypertensive cerebral hemorrhage. Methods: The clinical data of 120 patients with hypertensive intracerebral hemorrhage admitted to the Department of Neurosurgery of our hospital from October 2023 to February 2025 were retrospectively analyzed. According to different treatment methods, they were divided into craniotomy group (craniotomy patients, n = 40) and conservative group (conservative treatment patients, n = 80). The changes of ICP and blood routine indexes SII and NLR were compared 48 h, 72 h and 120 h after the onset of the two groups, and the relationship between peripheral blood SII and NLR and ICP in patients with hypertensive cerebral hemorrhage was analyzed. Results: The levels of ICP, SII and NLR in the two groups decreased 48 h, 72 h and 120 h after the onset of the disease (P < 0.05), and the ICP, SII and NLR in the craniotomy group were significantly higher than those in the conservative group (P < 0.05). The levels of SII and NLR in peripheral blood of patients in conservative group and craniotomy group were positively correlated with their ICP (P < 0.05). Conclusion: The levels of SII and NLR in peripheral blood of patients with hypertensive intracerebral hemorrhage showed a gradually decreasing trend 48 hours after the onset of the disease, and showed a dynamic positive correlation with ICP. Craniotomy can deepen the correlation degree. In clinical treatment, peripheral blood SII and NLR can be used as cytological markers to predict the risk of high ICP, providing a favorable information reference for clinicians to treat in time.