中华神经外科杂志
中華神經外科雜誌
중화신경외과잡지
Chinese Journal of Neurosurgery
2014年
6期
596-599
,共4页
杨彬%于思淼%王亮%刘晓智%赵玉军%刘振林
楊彬%于思淼%王亮%劉曉智%趙玉軍%劉振林
양빈%우사묘%왕량%류효지%조옥군%류진림
自发性脑出血%皮质醇%相关性
自髮性腦齣血%皮質醇%相關性
자발성뇌출혈%피질순%상관성
Spontaneous intracerebral hemorrhage%Cortisol%Relativity
目的 研究自发性脑出血后患者血清总皮质醇、皮质醇结合蛋白、游离皮质醇及游离皮质醇指数的变化,探讨其与患者病情轻重程度以及预后的关系.方法 筛选92例自发性脑出血患者,采用免疫分析法于患者发病后1、3、7、10和14 d晨6:00连续测定血清总皮质醇、皮质醇结合蛋白、游离皮质醇,并计算出游离皮质醇指数,采用SPSS 16.0统计学软件对实验结果数据进行分析研究,以P ＜0.05为差异有统计学意义.结果 发病第1天观察组较对照组血清总皮质醇、游离皮质醇和游离皮质醇指数均升高(P ＜0.001),之后逐渐下降.而皮质醇结合蛋白与对照组差异无统计学意义(P＞0.05),之后逐渐升高.血清皮质醇水平低下的自发性脑出血患者与血清皮质醇水平正常的患者比较预后不良(P＜0.05).结论 自发性脑出血可引起HPA轴的迅速激活,故发病后机体内的应激激素水平是升高的.当病情危重时,机体应激反应过于强烈,导致HPA轴衰竭,出现皮质醇不足,最终影响患者预后.
目的 研究自髮性腦齣血後患者血清總皮質醇、皮質醇結閤蛋白、遊離皮質醇及遊離皮質醇指數的變化,探討其與患者病情輕重程度以及預後的關繫.方法 篩選92例自髮性腦齣血患者,採用免疫分析法于患者髮病後1、3、7、10和14 d晨6:00連續測定血清總皮質醇、皮質醇結閤蛋白、遊離皮質醇,併計算齣遊離皮質醇指數,採用SPSS 16.0統計學軟件對實驗結果數據進行分析研究,以P ＜0.05為差異有統計學意義.結果 髮病第1天觀察組較對照組血清總皮質醇、遊離皮質醇和遊離皮質醇指數均升高(P ＜0.001),之後逐漸下降.而皮質醇結閤蛋白與對照組差異無統計學意義(P＞0.05),之後逐漸升高.血清皮質醇水平低下的自髮性腦齣血患者與血清皮質醇水平正常的患者比較預後不良(P＜0.05).結論 自髮性腦齣血可引起HPA軸的迅速激活,故髮病後機體內的應激激素水平是升高的.噹病情危重時,機體應激反應過于彊烈,導緻HPA軸衰竭,齣現皮質醇不足,最終影響患者預後.
목적 연구자발성뇌출혈후환자혈청총피질순、피질순결합단백、유리피질순급유리피질순지수적변화,탐토기여환자병정경중정도이급예후적관계.방법 사선92례자발성뇌출혈환자,채용면역분석법우환자발병후1、3、7、10화14 d신6:00련속측정혈청총피질순、피질순결합단백、유리피질순,병계산출유리피질순지수,채용SPSS 16.0통계학연건대실험결과수거진행분석연구,이P ＜0.05위차이유통계학의의.결과 발병제1천관찰조교대조조혈청총피질순、유리피질순화유리피질순지수균승고(P ＜0.001),지후축점하강.이피질순결합단백여대조조차이무통계학의의(P＞0.05),지후축점승고.혈청피질순수평저하적자발성뇌출혈환자여혈청피질순수평정상적환자비교예후불량(P＜0.05).결론 자발성뇌출혈가인기HPA축적신속격활,고발병후궤체내적응격격소수평시승고적.당병정위중시,궤체응격반응과우강렬,도치HPA축쇠갈,출현피질순불족,최종영향환자예후.
Objective To study the changes of total cortisol、cortisol binding globulin、free cortisol and free cortisol index in spontaneous cerebral hemorrhage patients,and to discuss the relationship between the changes and disease severity and the prognosis.Methods 92 patients with spontaneous intracerebral hemorrhage were enrolled in this study.The serum were collected at 6 am at the 1st day、3rd day、7th day、10th day and 14th day.The total cortisol、cortisol binding globulin and free cortisol were analyzed using of immunity method.The free cortisol index was calculated by Coolens equation.The data were analyzed with SPSS 16.0.Results The levels of total cortisol、free cortisol and free cortisol index showed significantly increased and got peak at the 1st day (P ＜ 0.001),and then gradually declined.The cortisol binding protein at the onset had no obvious difference (P ＞ 0.05),and then gradually increased.To compare the low cortisol spontaneous cerebral hemorrhage patients and the nomal cortisol spontaneous cerebral hemorrhage patients,the prognosis of the former was worse with statistical significance (P ＜ 0.05).Conclusions Quick activation of HPA axis could be caused by spontaneous cerebral hemorrhage.So the stress hormone levels in spontaneous cerebral hemorrhage patients were increased.When in a critical condition,the body's stress response was too strong and leaded to HPA axis failure,the cortisol was insufficient,and ultimately affected the prognosis of patients.
