| 谢竹霄,刘 磊,李 蕾,张景晓,王佳伟.外周血炎性指标及炎性复合指标对肥厚性硬脑膜炎诊断价值：附17例病例报告[J].,2022,(11):2051-2056 |
| 外周血炎性指标及炎性复合指标对肥厚性硬脑膜炎诊断价值：附17例病例报告 |
| Diagnostic Values of Peripheral Blood Inflammatory Index and Inflammatory Composite Index in Hypertrophic Pachymeningitis: A Case Series of 17 Patients |
| 投稿时间：2021-10-31 修订日期：2021-11-27 |
| DOI：10.13241/j.cnki.pmb.2022.11.009 |
| 中文关键词: 肥厚性硬脑膜炎 外周血 炎性复合指标 中性粒细胞与淋巴细胞比值 淋巴细胞与C-反应蛋白比值 |
| 英文关键词: Hypertrophic pachymeningitis Peripheral blood Inflammatory composite index Neutrophil to lymphocyte ratio Lymphocyte to C-reactive protein ratio |
| 基金项目:国家自然科学基金面上项目（81771313）；国家自然科学基金青年项目（81301029）；北京市自然科学基金面上项目（7192040）；北京市医院管理局"青苗"计划专项经费资助（QML20150206）；国家科技部重点研发计划项目（2016YFC0904502）；北京市科技计划课题"首都特色"项目（Z171100001017039）；首都医学发展重点攻关项目（2014-1-1101） |
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| 中文摘要: |
| 摘要 目的：寻找可作为肥厚性硬脑膜炎（hypertrophic pachymeningitis, HP）炎性标志物的外周血炎性指标及炎性复合指标。方法：纳入2015年4月至2019年12月期间在北京同仁医院神经内科住院治疗的17例HP患者，对其临床资料、影像学及实验室检查等进行回顾性归纳分析。统计HP最常见症状及首发症状，并对出院不同预后患者的临床资料进行比较。随后纳入32例与HP无明确相关性的其他神经系统非炎性疾病患者（non-inflammatory neurological diseases，OND）作为对照，分析两组外周血炎性指标及炎性复合指标之间差异，找寻在两组间具有鉴别诊断意义的炎性指标及炎性复合指标。结果：纳入HP患者平均年龄为50±16岁，男女比10:7。其中特发性HP 10例，继发性HP 7例。最常见症状为复视（12例），其次是头痛（10例）。最常见首发症状亦为复视（7例）。HP患者脑脊液白细胞数及蛋白水平正常。随访中发现原发性HP与继发性HP预后无差异。HP组和OND组除外周血类风湿因子（rheumatoid factors，RF）、红细胞沉降率（erythrocyte sedimentation rate，ESR）具有统计学差异外（P<0.05），中性粒细胞与淋巴细胞比值（neutrophil to lymphocyte ratio, NLR）这一炎性复合指标亦存在统计学差异（P<0.05）。同时发现上述三指标中ESR联合NLR对HP的排除诊断具有较高特异性。结论：HP按病因分为特发性和继发性。其临床表现多样，本组患者以复视为主要及首发症状，其次为头痛。本研究新发现炎性复合指标NLR在HP中升高且提示外周血急性炎症状态。同时，ESR会同NLR对该病的排除诊断具有重要意义。但炎性指标和炎性复合指标对于预后判断尚有待扩大样本量进一步研究。 |
| 英文摘要: |
| ABSTRACT Objective: To explore peripheral blood inflammatory index and inflammatory composite index in hypertrophic pachymeningitis（HP）as biomarkers of the disease. Methods: 17 patients diagnosed with HP in Department of Neurology, Beijing Tongren Hospital from April 2015 to December 2019 were enrolled and their clinical data, radiological features and laboratory findings were retrospectively analyzed. Frequencies of common symptoms and initial symptoms were also calculated and clinical data of patients with and without improvement when discharged were compared. 32 patients with other non-inflammatory neurological diseases (OND) served as control to compare peripheral blood inflammatory index and inflammatory composite index with HP patients. Results: Average age of 17 HP patients was 50±16 years old, and 10 patients were men. There were 10 idiopathic hypertrophic pachymeningitis patients and 7 secondary hypertrophic pachymeningitis patients. The most common symptoms of HP were diplopia (12 cases), followed by headache (10 cases), and the most common initial symptoms were also diplopia (7 cases). Cerebrospinal fluid white blood cell counts and protein level of HP patients were within normal ranges. There was no difference in prognosis during follow-up between primary and secondary hypertrophic pachymeningitis groups. There were statistical significances in rheumatoid factors and erythrocyte sedimentation rate of peripheral blood between HP and OND groups(P<0.05). Statistical significances in neutrophil to lymphocyte ratio (NLR), an inflammatory composite index was also found between two groups(P<0.05). Among three indexes, ESR together with NLR had excluded potential between HP and OND. Conclusion: HP can be divided into idiopathic and secondary with various clinical manifestations. The most common symptom and most common initial symptom in our HP patients is diplopia and followed by headache. Peripheral blood NLR was newly found elevated in HP and representing acute inflammatory status. And peripheral blood ESR along with NLR were found with excluded value as well. Prognosis values of inflammatory index and inflammatory composite index in HP are remain to be proved with more cases enrolled. |
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