脑出血急性期患者预后影响因素分析

摘要

Objective To explore the clinical value of biochemical indexes in patients with cerebral hemorrhage in acute stage.Methods Totally 90 cases with acute cerebral hemorrhage from February 2011 to February 2013 were enrolled and divided into poor prognosis group (14 cases) and good prognosis group (76 cases).The general information and serum biochemical indexes including lipoprotein (a),blood glucose,high-density lipoprotein cholesterol (HDL-C),low-density lipoprotein cholesterol (LDL-C),triacylglycerol,total cholesterol,blood uric acid,homocysteine (Hcy),high-sensitivity C-reactive protein (hs-CRP),serum creatinine were measured and compared between groups.The prognostic factors were analyzed by multiple Logistic regression analysis.Results The age,blood glucose,HDL-C,blood uric acid,hs-CRP,serum creatinine in poor prognosis group were significantly higher than those in good prognosis group [(72 ± 14) years vs (65 ± 11) years,(8.9 ±3.8) mmol/L vs (7.0 ±2.1) mmol/L,(1.6 ±0.5) mmo]/L vs (1.3 ±0.4) mmol/L,(371 ±123) μ mol/L vs (305±104) μmol/L,(14.9±2.5) mg/Lvs (6.6±1.7) mg/L,(136±43) μmol/L vs (113±23) μmol/L](P ＜0.05).The lipoprotein (a),LDL-C,triacylglycerol,total cholesterol,Hcy,hs-CRP were not significantlydifferent between groups [(260 ± 137) mg/L vs (253 ± 117) mg/L,(2.7 ± 1.1) mmol/L vs (2.7 ±0.9) mmol/L,(1.5 ± 1.3) mmol/L vs (1.5 ± 0.9) mmol/L,(4.9 ± 1.1) mmol/L vs (4.8 ± 1.0) mmol/L,(11 ± 7) μmol/L vs (12 ± 6) μmol/L,(1.27 ± 0.32) mg/L vs (1.19 ± 0.28) mg/L] (P ＞ 0.05).Multiple Logistic regression analysis showed that hs-CRP,HDL-C,blood glucose,serum creatinine,blood uric acid,age were correlated to prognosis (odds ratio =3.28,2.07,1.31,1.11,1.08,1.04,all P ＜0.05).Conclusion Hs-CRP,HDL-C,blood glucose,serum creatinine,blood uric acid and age are risk factors of poor prognosis in patients with intracerebral hemorrhage in acute stage.%目的 探讨脑出血急性期患者预后影响因素.方法 选取河南省新乡医学院第三附属医院2011年2月至2013年2月收治的脑出血急性期患者90例,根据预后情况分为预后不良组(14例)和预后良好组(76例).记录并比较2组患者一般资料和生化指标[血糖、脂蛋白(a)、高密度脂蛋白胆固醇(HDL-C)、低密度脂蛋白胆固醇(LDL-C)、三酰甘油、总胆固醇、血尿酸、同型半胱氨酸(Hcy)、高敏C反应蛋白(hs-CRP)、胱氨酸蛋白酶抑制物C(Cys C)、血肌酐],应用多元Logistic回归方法分析预后影响因素.结果 预后不良组患者年龄大于预后良好组[(72±14)岁比(65±11)岁]、血糖、HDL-C、血尿酸、hs-CRP、血肌酐水平明显均高于预后良好组[(8.9 ±3.8) mmol/L比(7.0±2.1)mmol/L、(1.6±0.5)mmo]/L比(1.3±0.4)mmol/L、(371±123) μmol/L比(305±104) μmol/L、(14.9±2.5) mg/L比(6.6±1.7)mg/L、(136 ±43) μmol/L比(113 ±23) μmol/L],差异均有统计学意义(均P＜0.05).预后不良组与预后良好组脂蛋白(a)、LDL-C、三酰甘油、总胆固醇、Hcy、Cys C水平比较[(260±137) mg/L比(253±117) mg/L、(2.7±1.1) mmol/L比(2.7 ±0.9) mmol/L、(1.5±1.3) mmol/L比(1.5±0.9)mmol/L、(4.9±1.1) mmol/L比(4.8±1.0) mmol/L、(11±7)μmol/L比(12±6)μmol/L、(1.27±0.32) mg/L比(1.19 ±0.28) mg/L],差异均无统计学意义(均P ＞0.05).多元Logistic回归分析显示,hs-CRP、HDL-C、血糖、血肌酐、血尿酸水平和年龄为预后影响因素(比值比=3.28、2.07、1.31、1.11、1.08、1.04,均P＜0.05).结论 血清hs-CRP、HDL-C、血糖、血肌酐、血尿酸水平以及年龄是急性期脑出血不良转归的危险因素.