Clinical significance of neutrophil to lymphocyte ratio and platelet to lymphocyte ratio in acute cerebral hemorrhage with gastrointestinal hemorrhage, and logistic regression analysis of risk factors

  • Authors:
    • Yu Zou
    • Wei Zhang
    • Chuanjun Huang
    • Yangqing Zhu
  • View Affiliations

  • Published online on: July 17, 2019     https://doi.org/10.3892/etm.2019.7778
  • Pages: 1533-1538
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Abstract

The aim of the present study was to determine the predictive value of the neutrophil to lymphocyte ratio (NLR) and platelet to lymphocyte ratio (PLR) in patients with acute cerebral hemorrhage with or without gastrointestinal hemorrhage. Risk factors of gastrointestinal hemorrhage in patients with acute cerebral hemorrhage were also assessed. A total of 335 patients with acute cerebral hemorrhage admitted to our hospital between January 2012 and January 2017 were enrolled. The 86 patients who experienced gastrointestinal hemorrhage during hospitalization were selected as the observation group, while the 249 remaining cases were assigned to the negative control group. The neutrophil, white blood cell and platelet count, as well as the NLR and PLR of each subject were recorded. Furthermore, sex, age, blood pressure, the site of cerebral hemorrhage, the amount of bleeding, the Glasgow Coma Scale (GCS) score and presence of hematosepsis were also recorded and assessed as potential risk factors for gastrointestinal hemorrhage in patients with acute cerebral hemorrhage. The NLR and PLR were markedly higher in the observation group compared with those in the negative control group. Furthermore, the NLR and PLR in the observation group were negatively associated with the 90‑day overall survival of patients with acute cerebral hemorrhage and gastrointestinal hemorrhage. In the negative control group, only the PLR was negatively associated with overall survival. Logistic regression analysis indicated that a cerebral hemorrhage volume of >30 ml, lower GCS score and hematosepsis were independently associated with gastrointestinal hemorrhage in patients with acute cerebral hemorrhage (P<0.05). A high NLR and PLR indicated an elevated risk of gastrointestinal hemorrhage in patients with acute cerebral hemorrhage. A higher NLR and PLR were also negatively associated with overall survival and prognosis of patients with cerebral hemorrhage. In addition, a cerebral hemorrhage volume of >30 ml, lower GCS score and hematosepsis were independent risk factors of gastrointestinal hemorrhage in patients with acute cerebral hemorrhage.

References

1 

Santoni M, Andrikou K, Sotte V, Bittoni A, Lanese A, Pellei C, Piva F, Conti A, Nabissi M, Santoni G and Cascinu S: Toll like receptors and pancreatic diseases: From a pathogenetic mechanism to a therapeutic target. Cancer Treat Rev. 41:569–576. 2015. View Article : Google Scholar : PubMed/NCBI

2 

O'Neill LA: The interleukin-1 receptor/Toll-like receptor superfamily: 10 years of progress. Immunol Rev. 226:10–18. 2008. View Article : Google Scholar : PubMed/NCBI

3 

Kawai T and Akira S: The role of pattern-recognition receptors in innate immunity: Update on toll-like receptors. Nat Immunol. 11:373–384. 2010. View Article : Google Scholar : PubMed/NCBI

4 

Kong Y and Le Y: Toll-like receptors in inflammation of the central nervous system. Int Immunopharmacol. 11:1407–1414. 2011. View Article : Google Scholar : PubMed/NCBI

5 

Abdi J, Engels F, Garssen J and Redegeld F: The role of toll-like receptor mediated signalling in the pathogenesis of multiple myeloma. Crit Rev Oncol Hematol. 80:225–240. 2011. View Article : Google Scholar : PubMed/NCBI

6 

Hammond MD, Taylor RA, Mullen MT, Ai Y, Aguila HL, Mack M, Kasner SE, McCullough LD and Sansing LH: CCR2+ Ly6C(hi) inflammatory monocyte recruitment exacerbates acute disability following intracerebral hemorrhage. J Neurosci. 34:3901–3909. 2014. View Article : Google Scholar : PubMed/NCBI

7 

Wang J and Dore S: Inflammation after intracerebral hemorrhage. J Cereb Blood Flow Metab. 27:894–908. 2007. View Article : Google Scholar : PubMed/NCBI

8 

Atkinson JJ and Senior RM: Matrix metalloproteinase-9 in lung remodeling. Am J Respir Cell Mol Biol. 28:12–24. 2003. View Article : Google Scholar : PubMed/NCBI

9 

Tian XC, Liu XL, Zeng FR, Chen Z and Wu DH: Platelet-to-lymphocyte ratio acts as an independent risk factor for patients with hepatitis B virus-related hepatocellular carcinoma who received transarterial chemoembolization. Eur Rev Med Pharmacol Sci. 20:2302–2309. 2016.PubMed/NCBI

10 

Suppiah A, Malde D, Arab T, Hamed M, Allgar V, Smith AM and Morris-Stiff G: The prognostic value of the neutrophil-lymphocyte ratio (NLR) in acute pancreatitis: Identification of an optimal NLR. J Gastrointest Surg. 17:675–681. 2013. View Article : Google Scholar : PubMed/NCBI

11 

Morotti A, Phuah CL, Anderson CD, Jessel MJ, Schwab K, Ayres AM, Pezzini A, Padovani A, Gurol ME, Viswanathan A, et al: Leukocyte count and intracerebral hemorrhage expansion. Stroke. 47:1473–1478. 2016. View Article : Google Scholar : PubMed/NCBI

12 

Gong C, Hoff JT and Keep RF: Acute inflammatory reaction following experimental intracerebral hemorrhage in rat. Brain Res. 871:57–65. 2000. View Article : Google Scholar : PubMed/NCBI

13 

Wijdicks EF: Cushing's ulcer: The eponym and his own. Neurosurgery. 68:1695–1698. 2011. View Article : Google Scholar : PubMed/NCBI

14 

Crooks CJ, Card TR and West J: Excess long-term mortality following non-variceal upper gastrointestinal bleeding: A population-based cohort study. PLoS Med. 10:e10014372013. View Article : Google Scholar : PubMed/NCBI

15 

Wijdicks EF, Fulgham JR and Batts KP: Gastrointestinal bleeding in stroke. Stroke. 25:2146–2148. 1994. View Article : Google Scholar : PubMed/NCBI

16 

Chen CM, Hsu HC, Chuang YW, Chang CH, Lin CH and Hong CZ: Study on factors affecting the occurrence of upper gastrointestinal bleeding in elderly acute stroke patients undergoing rehabilitation. J Nutr Health Aging. 15:632–636. 2011. View Article : Google Scholar : PubMed/NCBI

17 

Agnihotri S, Czap A, Staff I, Fortunato G and McCullough LD: Peripheral leukocyte counts and outcomes after intracerebral hemorrhage. J Neuroinflammation. 8:1602011. View Article : Google Scholar : PubMed/NCBI

18 

Imtiaz F, Shafique K, Mirza SS, Ayoob Z, Vart P and Rao S: Neutrophil lymphocyte ratio as a measure of systemic inflammation in prevalent chronic diseases in asian population. Int Arch Med. 5:22012. View Article : Google Scholar : PubMed/NCBI

19 

Gokhan S, Ozhasenekler A, Mansur DH, Akil E, Ustundag M and Orak M: Neutrophil lymphocyte ratios in stroke subtypes and transient ischemic attack. Eur Rev Med Pharmacol Sci. 17:653–657. 2013.PubMed/NCBI

20 

Lattanzi S, Cagnetti C, Provinciali L and Silvestrini M: Neutrophil-to-lymphocyte ratio predicts the outcome of acute intracerebral hemorrhage. Stroke. 47:1654–1657. 2016. View Article : Google Scholar : PubMed/NCBI

21 

Altintas O, Altintas MO, Tasal A, Kucukdagli OT and Asil T: The relationship of platelet-to-lymphocyte ratio with clinical outcome and final infarct core in acute ischemic stroke patients who have undergone endovascular therapy. Neurol Res. 38:759–765. 2016. View Article : Google Scholar : PubMed/NCBI

22 

Tao C, Wang J, Hu X, Ma J, Li H and You C: Clinical value of neutrophil to lymphocyte and platelet to lymphocyte ratio after aneurysmal subarachnoid hemorrhage. Neurocrit Care. 26:393–401. 2017. View Article : Google Scholar : PubMed/NCBI

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September 2019
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APA
Zou, Y., Zhang, W., Huang, C., & Zhu, Y. (2019). Clinical significance of neutrophil to lymphocyte ratio and platelet to lymphocyte ratio in acute cerebral hemorrhage with gastrointestinal hemorrhage, and logistic regression analysis of risk factors. Experimental and Therapeutic Medicine, 18, 1533-1538. https://doi.org/10.3892/etm.2019.7778
MLA
Zou, Y., Zhang, W., Huang, C., Zhu, Y."Clinical significance of neutrophil to lymphocyte ratio and platelet to lymphocyte ratio in acute cerebral hemorrhage with gastrointestinal hemorrhage, and logistic regression analysis of risk factors". Experimental and Therapeutic Medicine 18.3 (2019): 1533-1538.
Chicago
Zou, Y., Zhang, W., Huang, C., Zhu, Y."Clinical significance of neutrophil to lymphocyte ratio and platelet to lymphocyte ratio in acute cerebral hemorrhage with gastrointestinal hemorrhage, and logistic regression analysis of risk factors". Experimental and Therapeutic Medicine 18, no. 3 (2019): 1533-1538. https://doi.org/10.3892/etm.2019.7778