• Wanqiang Su, Chuang Gao, Peng Wang, Jinhao Huang, Yu Qian, Linyue Guo, Jianning Zhang, and Rongcai Jiang.
• Department of Neurosurgery, Tianjin Medical University General Hospital and Tianjin Neurological Institute, Key Laboratory of Postneurotrauma Neurorepair and Regeneration in Central Nervous System, Ministry of Education, Tianjin Key Laboratory of Injuries, Variations, and Regeneration of Nervous System, Tianjin, China; Department of Neurosurgery, First Center Hospital of Baoding, Hebei, China.
• World Neurosurg. 2017 Nov 1; 107: 389-395.

BackgroundThe close correlation between intracerebral pressure (ICP) and immunologic responses has been well described, but the role of T lymphocytes in this process remains unknown. This study targeted the relationship of circulating T lymphocytes and ICP in patients with intracerebral hemorrhage (ICH).MethodsBetween October 2015 and October 2016, consecutive patients age 18-65 years with ICH were enrolled. ICP values were recorded hourly for 5 days, and the screened patients were divided into 2 groups based on ICP: the elevated ICP group (ICP >20 mmHg) and normal ICP group (ICP ≤20 mmHg). Peripheral blood was collected on admission and T lymphocyte subpopulations were analyzed by flow cytometry. Glasgow Coma Scale score on admission and Glasgow Outcome Scale (GOS) score at 30 days after ICH were analyzed.ResultsA total of 44 patients were enrolled, including 18 patients in the elevated ICP group and 26 in the normal ICP group. Both CD3+ and CD4+ T lymphocyte counts were higher in the elevated ICP group (P = 0.004 and 0.000, respectively). The CD8+ T lymphocyte count was not significantly different between the 2 groups (P = 0.751). There were correlation trends between the maximum ICP value and CD3+ lymphocyte count (P = 0.003), CD4+ T lymphocyte count (P = 0.000), and the CD4+/CD8+ T lymphocyte ratio (P = 0.000). The area under the curve (AUC) of CD4+/CD8+ T lymphocyte ratio was the largest among them (P = 0.011 and 0.033), with a significant cutoff value and good specificity and sensitivity. There was a close correlation between the CD4+/CD8+ T lymphocyte ratio and the 30-day GOS score (P = 0.003, AUC = 0.812).ConclusionsThe CD4+/CD8+ T lymphocyte ratio may be a valuable indicator for predicting postoperative ICP and the short-term prognosis after ICH.Copyright © 2017. Published by Elsevier Inc.

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