摘要
目的研究血清离子钙与高血压脑出血患者血肿量早期变化和预后的相关性。方法选择2020年1月-2020年11月在东莞市桥头医院进行治疗的72例高血压脑出血患者作为研究对象,根据其入院后24h内血肿变化情况将其分为血肿扩大组(HE组,41例)及血肿未扩大组(非HE组,31例)。同时,收集两组入院时血清离子钙、血清总钙、凝血功能检测资料及格拉斯预后量表(GCS)评分结果,于随访3个月后采用改良Rankin量表(mRS评分)评估其预后;采用Spearman相关性、多因素Logistic回归分析血清离子钙水平对高血压脑出血患者血肿量早期变化、预后的影响。结果与非HE组相比,HE组血肿体积增速较快、血清离子钙及血清总钙水平较低、活化部分凝血活酶时间(APTT)及凝血酶原时间(PT)较长、血清抗凝血酶浓度较低、GCS评分较低;随访3个月后可见,HE组中预后不良者占比为87.80%,高于非HE组的58.06%(P<0.05);HE组随访期内不良反应总发生率为21.95%,高于非HE组的3.23%(P<0.05)。多因素Logistic回归分析显示血清离子钙水平、HE扩大均为患者不良预后危险因素,OR值分别为2.743、2.062,Spearman相关性分析显示患者血清离子钙水平与其血肿量早期变化存在相关性。结论血清离子钙水平与高血压脑出血患者血肿量早期变化及预后有显著相关性,血清离子钙水平降低、HE扩大者预后不良的可能性较大。
Objective To study the correlation between serum calcium ion and early changes of hematoma volume and prognosis in patients with hypertensive intracerebral hemorrhage.Methods A total of 72 patients with hypertensive intracerebral hemorrhage treated in Qiaotou Hospital of Dongguan city from January 2020 to November 2020 were selected as the study subjects.According to the changes of hematoma within 24hours after admission,they were divided into the expanded hematoma group(HE group,41 cases)and the non-expanded hematoma group(non-HE group,31 cases).At the same time,serum ionic calcium,serum total calcium,blood coagulation function and Glass prognosis Scale(GCS)scores were collected at admission,and the prognosis of the two groups was assessed by modified Rankin scale(mRS score)after 3 months of follow-up.Spearman correlation and Logistic regression were used to analyze the influence of serum calcium ion level on the early changes of hematoma volume and prognosis in hypertensive intracerebral hemorrhage patients.Results Compared with non-HE group,the volume of hematoma in HE group increased faster,the levels of ionic calcium and total calcium in serum were lower,the activated partial thrombin time(APTT)and prothrombin time(PT)were longer,the serum antithrombin concentration was lower,and the GCS score was lower.After 3 months of follow-up,the proportion of poor prognosis in HE group was 87.80%,which was higher than 58.06%in non-HE group(P<0.05).The total incidence of adverse reactions in HE group was 21.95%,which was higher than that in non-HE group(3.23%,P<0.05).Multivariate Logistic regression analysis showed that serum calcium level and HE enlargement were risk factors for poor prognosis,and THE OR values were 2.743 and 2.062,respectively.Spearman correlation analysis showed that there was a correlation between serum calcium level and early changes of hematoma volume.Conclusion There is a significant correlation between serum calcium level and the early changes of hematoma volume and prognosis in patients with hypertensive intracerebral hemorrhage.Patients with reduced serum calcium level and increased HE are more likely to have poor prognosis.
作者
陈小飞
CHEN Xiao-fei(Department of Critical Care medicine,Qiaotou Hospital,Dongguan,Guangdong 523520)
出处
《智慧健康》
2022年第1期85-87,共3页
Smart Healthcare
基金
东莞市社会科技发展项目,项目名称:血清离子钙与高血压脑出血患者血肿量早期变化和预后相关性的研究,项目编号:202050715036813
关键词
血清离子钙
高血压脑出血
血肿量早期变化
格拉斯预后量表
Serum calcium ion
Hypertensive cerebral hemorrhage
Early changes of hematoma volume
Glass prognosis Scale
作者简介
陈小飞(1981-),男,广东茂名,汉族,大学本科,副主任医师,重症医学科。
