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已发表论文
利用炎症血液学指标预测脑出血相关性肺炎抗生素疗效：一项回顾性研究
Authors Wang X, Yang X, Yao Y, Hu H, Zhao Y, Zhu Z
Received 16 July 2025
Accepted for publication 30 September 2025
Published 4 October 2025 Volume 2025:18 Pages 13763—13772
DOI https://doi.org/10.2147/JIR.S553806
Checked for plagiarism Yes
Review by Single anonymous peer review
Peer reviewer comments 2
Editor who approved publication: Dr Tara Strutt
Xian Wang,1,* Xiong Yang,2,* Yuan Yao,2,* Hang Hu,3 Yongfeng Zhao,4 Zhansheng Zhu2
1Department of Pharmacy, The First Affiliated Hospital of Yangtze University, Jingzhou, People’s Republic of China; 2Department of Neurosurgery, The First Affiliated Hospital of Yangtze University, Jingzhou, People’s Republic of China; 3Neurointensive Care Unit, The First Affiliated Hospital of Yangtze University, Jingzhou, People’s Republic of China; 4Department of Hematology, The First Affiliated Hospital of Yangtze University, Jingzhou, People’s Republic of China
*These authors contributed equally to this work
Correspondence: Yongfeng Zhao, Department of Hematology, The First Affiliated Hospital of Yangtze University, Jingzhou, Hubei, People’s Republic of China, Email zhaoyongfeng2529@163.com Zhansheng Zhu, Department of Neurosurgery, The First Affiliated Hospital of Yangtze University, Jingzhou, Hubei, People’s Republic of China, Email zzs2341@yangtzeu.edu.cn
Purpose: The role of inflammatory response in secondary infections following cerebral hemorrhage has attracted considerable attention. We aimed to explore the associations between inflammatory markers and antibiotic efficacy on the cerebral hemorrhage-associated pneumonia.
Methods: We conducted a retrospective study including 200 patients with cerebral hemorrhage-associated pneumonia. In the retrospective study, baseline data, blood cell counts, and C-reactive protein (CRP) were collected. The inflammatory markers including neutrophil–lymphocyte ratio (NLR), platelet-lymphocyte ratio (PLR), monocyte–lymphocyte ratio (MLR), systemic immune-inflammatory index (SII) were calculated. The difference between the values at admission and at the time of initial efficacy evaluation was denoted by “Δ”. These inflammatory markers were examined as potential biomarkers to predict the efficacy of initial antibiotic treatment in finally included patients by univariate analysis and multivariate logistic regression models.
Results: In the final analysis, there were 105 cases with effective antibiotic treatment and 95 cases with ineffective antibiotic treatment. At the time of initial efficacy evaluation, there were significant differences in the values of NLR, MLR, PLR, SII, and CRP, P< 0.05. Significant differences were also showed in the values of ΔNLR, ΔMLR, and ΔSII, P< 0.05. The results of multivariate logistic regression model showed that ΔNLR (OR: 1.260, P=0.016), ΔPLR (OR: 0.985, P=0.008), and CRP (OR: 0.975, P=0.043) at the time of efficacy evaluation were possibly associated with the antibiotic efficacy.
Conclusion: ΔNLR, ΔPLR, and CRP at the time of efficacy evaluation appear the promising parameters in guiding antibiotic treatment in patients with cerebral hemorrhage-associated pneumonia. However, large-sample, multicenter external validation studies are still needed.
Keywords: cerebral hemorrhage, pneumonia, platelet–lymphocyte ratio, neutrophil–lymphocyte ratio, systemic immune-inflammatory index
1Department of Pharmacy, The First Affiliated Hospital of Yangtze University, Jingzhou, People’s Republic of China; 2Department of Neurosurgery, The First Affiliated Hospital of Yangtze University, Jingzhou, People’s Republic of China; 3Neurointensive Care Unit, The First Affiliated Hospital of Yangtze University, Jingzhou, People’s Republic of China; 4Department of Hematology, The First Affiliated Hospital of Yangtze University, Jingzhou, People’s Republic of China
*These authors contributed equally to this work
Correspondence: Yongfeng Zhao, Department of Hematology, The First Affiliated Hospital of Yangtze University, Jingzhou, Hubei, People’s Republic of China, Email zhaoyongfeng2529@163.com Zhansheng Zhu, Department of Neurosurgery, The First Affiliated Hospital of Yangtze University, Jingzhou, Hubei, People’s Republic of China, Email zzs2341@yangtzeu.edu.cn
Purpose: The role of inflammatory response in secondary infections following cerebral hemorrhage has attracted considerable attention. We aimed to explore the associations between inflammatory markers and antibiotic efficacy on the cerebral hemorrhage-associated pneumonia.
Methods: We conducted a retrospective study including 200 patients with cerebral hemorrhage-associated pneumonia. In the retrospective study, baseline data, blood cell counts, and C-reactive protein (CRP) were collected. The inflammatory markers including neutrophil–lymphocyte ratio (NLR), platelet-lymphocyte ratio (PLR), monocyte–lymphocyte ratio (MLR), systemic immune-inflammatory index (SII) were calculated. The difference between the values at admission and at the time of initial efficacy evaluation was denoted by “Δ”. These inflammatory markers were examined as potential biomarkers to predict the efficacy of initial antibiotic treatment in finally included patients by univariate analysis and multivariate logistic regression models.
Results: In the final analysis, there were 105 cases with effective antibiotic treatment and 95 cases with ineffective antibiotic treatment. At the time of initial efficacy evaluation, there were significant differences in the values of NLR, MLR, PLR, SII, and CRP, P< 0.05. Significant differences were also showed in the values of ΔNLR, ΔMLR, and ΔSII, P< 0.05. The results of multivariate logistic regression model showed that ΔNLR (OR: 1.260, P=0.016), ΔPLR (OR: 0.985, P=0.008), and CRP (OR: 0.975, P=0.043) at the time of efficacy evaluation were possibly associated with the antibiotic efficacy.
Conclusion: ΔNLR, ΔPLR, and CRP at the time of efficacy evaluation appear the promising parameters in guiding antibiotic treatment in patients with cerebral hemorrhage-associated pneumonia. However, large-sample, multicenter external validation studies are still needed.
Keywords: cerebral hemorrhage, pneumonia, platelet–lymphocyte ratio, neutrophil–lymphocyte ratio, systemic immune-inflammatory index