中华神经医学杂志
中華神經醫學雜誌
중화신경의학잡지
CHINESE JOURNAL OF NEUROMEDICINE
2009年
1期
67-70
,共4页
童道明%苏晓清%廖杰芳%胡建康%易飞%贺琼
童道明%囌曉清%廖傑芳%鬍建康%易飛%賀瓊
동도명%소효청%료걸방%호건강%역비%하경
脑卒中%高渗状态%糖尿病%全身炎症反应综合征%甘露醇
腦卒中%高滲狀態%糖尿病%全身炎癥反應綜閤徵%甘露醇
뇌졸중%고삼상태%당뇨병%전신염증반응종합정%감로순
Stroke%Hyperosmolar state%Diabetes%Systemic inflammatory responsesyndrome%Marmitol
目的 探讨脑卒中患者高渗状态的危险因素. 方法 收集脑卒中合并高渗状态患者32例做为高渗状态组,抽取同期非高渗状态的脑卒中患者63例为对照组.采用Logistic回归分析确定脑卒中患者高渗状态的危险因素. 结果 高渗状态组平均血浆渗透压[(338.8±12.5)mOsm/L]明显高于对照组[(285.7±11.7)mOsm/L],高渗状态组平均GCS分值[(6.9±2.7)分)]明显低于对照组[(12.7±3.5)分],差异均有统计学意义(P<0.05).多因素Logistic回归分析证实,糖尿病(OR=0.043,95%CI=0.007～0.277,P=0.001)、全身炎症反应综合征(SIRS)(OR=0.550,95%CI=0.388～0.780,P=0.001)、甘露醇用量(OR=0.973,95%CI=0.955～0.991,P=0.004)是脑卒中患者高渗状态的危险因素. 结论 糖尿病、SIRS、甘露醇用量可以联合或单独作用引起高渗状态,治疗过程中重视这三项指标的监测将有助于卒中患者的康复.
目的 探討腦卒中患者高滲狀態的危險因素. 方法 收集腦卒中閤併高滲狀態患者32例做為高滲狀態組,抽取同期非高滲狀態的腦卒中患者63例為對照組.採用Logistic迴歸分析確定腦卒中患者高滲狀態的危險因素. 結果 高滲狀態組平均血漿滲透壓[(338.8±12.5)mOsm/L]明顯高于對照組[(285.7±11.7)mOsm/L],高滲狀態組平均GCS分值[(6.9±2.7)分)]明顯低于對照組[(12.7±3.5)分],差異均有統計學意義(P<0.05).多因素Logistic迴歸分析證實,糖尿病(OR=0.043,95%CI=0.007～0.277,P=0.001)、全身炎癥反應綜閤徵(SIRS)(OR=0.550,95%CI=0.388～0.780,P=0.001)、甘露醇用量(OR=0.973,95%CI=0.955～0.991,P=0.004)是腦卒中患者高滲狀態的危險因素. 結論 糖尿病、SIRS、甘露醇用量可以聯閤或單獨作用引起高滲狀態,治療過程中重視這三項指標的鑑測將有助于卒中患者的康複.
목적 탐토뇌졸중환자고삼상태적위험인소. 방법 수집뇌졸중합병고삼상태환자32례주위고삼상태조,추취동기비고삼상태적뇌졸중환자63례위대조조.채용Logistic회귀분석학정뇌졸중환자고삼상태적위험인소. 결과 고삼상태조평균혈장삼투압[(338.8±12.5)mOsm/L]명현고우대조조[(285.7±11.7)mOsm/L],고삼상태조평균GCS분치[(6.9±2.7)분)]명현저우대조조[(12.7±3.5)분],차이균유통계학의의(P<0.05).다인소Logistic회귀분석증실,당뇨병(OR=0.043,95%CI=0.007～0.277,P=0.001)、전신염증반응종합정(SIRS)(OR=0.550,95%CI=0.388～0.780,P=0.001)、감로순용량(OR=0.973,95%CI=0.955～0.991,P=0.004)시뇌졸중환자고삼상태적위험인소. 결론 당뇨병、SIRS、감로순용량가이연합혹단독작용인기고삼상태,치료과정중중시저삼항지표적감측장유조우졸중환자적강복.
Objective To study the risk factors for hyperosmolar state in stroke patients. Methods The clinical data of 32 stroke patients with hyperosmolar state (HS group) and 63 randomly selected stroke patients without hyperosmolar state (control group) were analyzed. The hyperosmolar state was defined as the plasma osmotic pressure >320 mOsm/L, and logistic regression was performed to identify the risk factors for hyperosmolar state in the stroke patients. Results The mean plasma osmotic pressure in the HS group was significantly higher than that in the control group (338.8±12.5 vs 285.7±11.7 mOsm/L, P<0.05). The stroke patients with hyperosmolar state had a significantly lower mean Glasgow Coma Score than the control patients (6.9±2.7 vs 12.7±3.5, P<0.05). Multiple logistic regression analysis showed that diabetes (OR=0.043, 95%CI=0.007-0.277, P=0.001), systemic inflammatory response syndrome (SIRS) (OR=0.550, 95%CI=0.388-0.780, P=0.001), and the daily dose of mannitol (OR=0.973, 95%CI=0.955-0.991, P=0.004) were the risk factors for hyperosmolar state in stroke patients. Conclusion Diabetes, SIRS and the daily mannitol dose are the risk factors for hypreosmolar state in stroke patients, and by acting jointly or separately, these risk factors are responsible for the onset ofhypreosmolar state.
