目的 探讨老年急性脑血管病合并多脏器功能衰竭(MOF)患者的临床特征,为其防治提供参考.方法 老年急性脑血管病合并MOF患者216例为老年组,同期72例中青年急性脑血管病合并MOF患者为中青年组.对比分析两组患者急性脑血管病类型(脑梗死或脑出血)及部位、脑梗死面积、脑出血量、并发MOF数目及分布、死亡率.结果 老年组中脑梗死占47.2％,显著高于中青年组(25％,x2=21.286,P=0.002);老年组中大面积梗死者显著低于中青年组(x2=12.368,P=0.016),而小面积梗死者及腔隙性脑梗死者在老年组中的比例均显著高于中青年组(x2=32.685、64.368,P=0.001、0.000).老年组中脑出血发生率(52.8％)显著低于中青年组(75％,x2=9.864,P=0.026);老年组中大量出血者占66.7％,显著低于中青年组(85.2％,x2=6.486,P=0.036);老年组中中量出血和小量出血均显著高于中青年组(x2 =26.246、28.328,P=0.003、0.002).两组中脑出血及脑梗死发生部位无显著差异(P＞0.05).老年组并发MOF的诱因以肺部感染最多见(65.7％).老年组2个脏器衰竭的比例低于中青年组(x2=6.392,P=0.038),4、5、6个脏器衰竭均分别显著高于中青年组(x2=16.384、12.648、15.862,P=0.003、0.006、0.004).老年组中肾功能衰竭比例显著高于中青年组(x2=6.216,P=0.041).结论 老年急性脑血管病并发MOF的临床特征与中青年组相比发生率高,死亡率高,即使在急性脑血管病病情相对较轻的情况下,也会并发MOF,并且MOF受累器官增多,病情更加危重.%Objective To explore the clinical features of elder aged patients with acute cerebrovascular disease combined with multiple organ failure (MOF) and to provide evidence for its prevention and cure. Methods 216 elder aged patients with acute cerebrovascular disease combined with MOF were regarded as elder group, and 72 middle or young aged patients with acute cerebrovascular disease combined with MOF were considered as middle-young group. The types of acute cerebrovascular (cerebral infarction or hemorrhage), cerebral infarct size, cerebral hemorrhage value, MOF numbers and distribution and death rate were contrastive analyzed. Results There were 47. 2% patients with cerebral infarction in elder group which was significant higher than in middle-young group(25%) , (x2 =21. 286, P = 0. 002), The patients with large size infarction in elder group were more than in middle-young group (x2 = 12. 368, P = 0. 016), but the patients with small size of infarction or lacunar infarction were less (x2 =32. 685, 64. 368,P = 0. 001, 0. 000). The incidence rate of cerebral hemorrhage in elder group(52. 8%) was obviously lower than middle-young group (x2 =9. 864,P = 0.026). The rate of massive hemorrhage in elder group(66. 7%) was obviously lower than middle-young group(85. 2%) (x2=6. 486,P=0. 036), but the rate of middle or less volume of hemorrhage was higher(x2=26. 246, 28.328, P = 0.003, 0.002). There was no obviously difference of distribution of cerebral infarction or hemorrhage in the two groups. The pulmonary inflammation (65. 7%) was the main precipitating factor of MOF in elder group. The ratio of 2 organs failure in elder group was lower than middle-young group (x2 = 6.392,P = 0. 038), but 4, 5 or 6 organ failures were higher (x2 = 16. 384, 12. 648, 15. 862,P=0. 003, 0. 006, 0. 004). The incidence rate of renal failure in elder group was higher than middle-young group (X2 = 6. 216, P=0. 041). Conclusion Compared to middle-young aged patients, the elder one has high incidence rate and death rate of acute cerebrovascular disease combined with multiple organ failure (MOF). Moreover, even a less severe acute cerebrovascular disease can cause MOF for elder aged patients and their disease conditions are more danger.
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