CAJ | 학술논문

目的探索青年自发性脑出血预后的相关因素及其预测价值.方法回顾性收集2008年至2011年所有入住苏北人民医院的首次急性自发性脑出血青年患者.使用逐步logistic回归法分析30 d的死亡及预后良好(mRS评分为0～2)的因素,使用受试者工作特征曲线分析各因素的预测价值.结果青年自发性脑出血30 d死亡的危险因素有:合并高血压病(P =0.023)或糖尿病(P =0.007)、幕下血肿(P =0.000)、血肿体积大(P =0.008)、GCS评分低(P =0.000)、外周血白细胞高(P=0.000)、血糖高(P =0.039)、凝血酶原时间长(P=0.001).预后良好的独立因素有:年纪轻(P=0.001)、无高血压病(P =0.010)或糖尿病(P =0.028)、血肿体积小(P =0.000)、NIHSS评分低(P=0.000)、外周血白细胞低(P=0.000)、血糖低(P=0.012)、收缩压水平低(P =0.000).其中NIHSS评分及GCS评分对预后判断具有很高的价值,收缩压、外周血白细胞及血肿体积对预后也有较好的预测作用.结论青年自发性脑出血短期预后判断时应综合考虑各因素及其预测价值.
목적 탐색청년자발성뇌출혈예후적상관인소급기예측개치.방법 회고성수집2008년지2011년소유입주소북인민의원적수차급성자발성뇌출혈청년환자.사용축보logistic회귀법분석30 d적사망급예후량호(mRS평분위0～2)적인소,사용수시자공작특정곡선분석각인소적예측개치.결과 청년자발성뇌출혈30 d사망적위험인소유:합병고혈압병(P =0.023)혹당뇨병(P =0.007)、막하혈종(P =0.000)、혈종체적대(P =0.008)、GCS평분저(P =0.000)、외주혈백세포고(P=0.000)、혈당고(P =0.039)、응혈매원시간장(P=0.001).예후량호적독립인소유:년기경(P=0.001)、무고혈압병(P =0.010)혹당뇨병(P =0.028)、혈종체적소(P =0.000)、NIHSS평분저(P=0.000)、외주혈백세포저(P=0.000)、혈당저(P=0.012)、수축압수평저(P =0.000).기중NIHSS평분급GCS평분대예후판단구유흔고적개치,수축압、외주혈백세포급혈종체적대예후야유교호적예측작용.결론 청년자발성뇌출혈단기예후판단시응종합고필각인소급기예측개치.
Objective To study factors used to predict 30-day mortality and favorable outcomes to intracerebral hemorrhage (ICH) in young adult subjects and to estimate the reliability of these predictors.Methods Data of 175 acute ICH patients selected from 201 patients admitted to our hospital from 2008 to 2011 were reviewed retrospectively.Patients were assessed with Glasgow Coma Scale (GCS) and National Institutes of Health Stroke Scale (NIHSS) and routine laboratory examinations after admission.Independent predictors of 30-day mortality or good outcome (modified Rankin score,0-2) were identified by stepwise logistic regression.Results There were 90 male and 85 female,and 142 survivals and 33 deaths.The modified Rankin score (mRS) of survival group was ＜6 and mRS =6 in death group,and mRS ＜3 in good outcome group and mRS ＞ or =3 in poor outcome group.Independent factors for 30-day mortality were hypertension (P =0.023) or hyperglycemia (P =0.007),infra-tentorial ICH (P =0.000),large ICH volume (P =0.008),low Glasgow Coma Scale (GCS) scores (P =0.000),high white blood cell count (P =0.000),higher blood glucose level (P =0.039) and prothrombin time (PT) (P =0.001) after admission.Independent factors for 30-day good outcome were younger age (P =0.001),normal blood pressure (P=0.010) or absence of hyperglycemia (P=0.028),lower NIHSS scores (P=0.000),small ICH volume (P =0.000),low white blood cell (WBC) count (P =0.000),lower blood glucose level (P =0.012) or lower systolic blood pressure (SBP) level (P =0.000) at admission.The NIHSS score and GCS score were excellent predictors,while the SBP level,WBC count and ICH volume were fine predictors.Conclusions Overall prognostic factors should be integrated to get high reliabilities for predicting the outcomes of ICH in young people.