摘要：
目的 探讨自发性颅内出血(spontaneous intracerebral hemorrhage,SIH)患者30 d内死亡的危险因素.方法 回顾性分析2012-)1至2016-)1医院收治的SIH患者324例.30 d内死亡82例,为死亡组,其余242例存活患者为存活组,统计分析两组患者入院时主要临床特征.单因素和多因素logistic回归分析显示格拉斯哥昏迷评分降低、糖尿病、小脑出血、出血量增加和脑室出血等死亡的危险因素.结果 与存活组比较,死亡组年龄显著偏大[(54.38±12.47)岁vs (51.73±11.94)岁,P=0.028];高血压病显著增加(68.29％ vs55.79％,P=0.047),;糖尿病显著增加(46.34％ vs 27.69％,P=0.002);吸烟率显著增加(35.37％vs21.07％,P=0.009);小脑出血率显著增高(20.73％ vs 8.68％,P=0.003);脑室出血率显著增高(74.39％ vs 54.96％,P=0.002);手术率显著降低(20.73％ vs 37.19％,P=0.006);出血量显著增多[(110.98±36.96)ml vs (77.04 ±31.81)ml,t=4.922,P=0.000];格拉斯哥昏迷评分显著降低(7.52 ±2.70 vs 9.54 ±2.06,t=4.207,P =0.000).结论 格拉斯哥昏迷评分降低、糖尿病、小脑出血、出血量增加和脑室出血是SIH患者30 d内死亡的危险因素.%Objective To explore the risk factors of 30-day mortality in patients with spontaneous intracranial hemorrhage (SIH).Methods Three hundred and twenty-four patients with SIH admitted to our hospital between January 2012 and January 2016 were retrospectively studied.Eight-two patients who died within 30 days were assigned to a death group,while another 242 survivors were assigned to a survival group.The main clinical features of both groups were observed.Univariate and multivariate logistic regression analysis was used to study such risk factors for death as a decrease of Glasgow coma score,diabetes,cerebellar hemorrhage,an increased amount of hemorrhage and intraventricular hemorrhage.Results When compared with the survival group,patients in the death group had significantly older ages (54.38 ± 12.47 vs 51.73 ± 11.94,P =0.028),a higher rate of hypertension (68.29％ vs 55.79％,P=0.047),diabetes (46.34％ vs 27.69％,P=0.002)and of smoking (35.37％ vs 21.07％,P =0.009).The rate of cerebellar hemorrhage increased apparently (20.73％ vs 8.68％,P =0.003),the rate of intraventricular hemorrhage increased significantly (74.39％ vs 54.96％,P =0.002),the surgical rate decreased (20.73％ vs 37.19％,P =0.006),the amount of bleeding increased apparently [(110.98 ± 36.96) ml vs (77.04 ± 31.81) ml,t =4.922,P =0.000] and the Glasgow coma score decreased significantly (7.52 ±2.70 vs 9.54 ±2.06,t =4.207,P=0.000).Conclusions A decrease in Glasgow coma scale,diabetes,cerebellar hemorrhage,an increased amount of hemorrhage and cerebral ventricular hemorrhage are risk factors for 30-day mortality in patients with SIH.
