老年自发性脑出血病人早期神经功能恶化的危险因素研究

doi:10.3969/j.issn.1003-9198.2024.06.007

摘要/Abstract

摘要： 目的探讨老年自发性脑出血(SICH)病人早期神经功能恶化(END)的危险因素。方法回顾性分析2019年1月至2022年9月本院收治的100例老年SICH病人的临床资料,根据NIHSS评估结果分为非END组(n=60)与END组(n=40)。比较2组一般资料及实验室指标Hcy、CRP水平,采用多因素Logistic回归分析各指标与END的相关性。结果 100例SICH病人中END发生率为40.00％(40／100)。非END组高血压、出血破入脑室占比以及血肿体积、CRP、Hcy水平低于END组(P<0.05)。多因素Logistic回归分析结果显示,高血压、血肿体积、出血破入脑室、CRP、Hcy是老年SICH病人发生END的危险因素(P<0.05)。结论老年SICH病人发生END受较多因素影响,当血肿体积、CRP、Hcy增高时,需注意END的发生。

关键词: 自发性脑出血, 早期神经功能恶化, 同型半胱氨酸, C反应蛋白

Abstract: Objective To explore the risk factors of early neurological deterioration (END) in the elderly patients with spontaneous intracerebral hemorrhage (SICH). Methods A retrospective analysis was conducted on the clinical data of 100 elderly patients with SICH admitted to our hospital from January 2019 to September 2022. According to the results of the National Institutes of Health Stroke Scale (NIHSS), all patients were divided into non-END group (n=60) and END group (n=40). The general information and laboratory indicators including homocysteine (Hcy) and C-reactive protein (CRP) were collected and compared between the two groups.Multivariate Logistic regression analysis was used to analyze the influencing factors of END in the elderly patients with SICH. Results The incidence rate of END in 100 patients with SICH was 40.00％ (40／100). The proportion of hypertension, hemorrhage breaking into the ventricle, hematoma volume, and the levels of CRP and Hcy in the non-END group were lower than those in the END group (P<0.05). The results of multivariate Logistic regression analysis showed that hypertension, hematoma volume, intraventricular hemorrhage, CRP and Hcy were risk factors for the occurrence of END in the elderly patients with SICH. Conclusions The occurrence of END in patients with SICH is influenced by multiple factors. When the volume of hematoma, CRP and HCY increase, attention should be paid to the occurrence of END.

Key words: spontaneous intracerebral hemorrhage, early deterioration of neurological function, homocysteine, C-reactive protein

中图分类号:

R743.34

张要田, 周勇, 王军宝, 马昌宝. 老年自发性脑出血病人早期神经功能恶化的危险因素研究[J]. 实用老年医学, 2024, 38(6): 568-571.

ZHANG Yaotian, ZHOU Yong, WANG Junbao, MA Changbao. Risk factors for early neurological deterioration in elderly patients with spontaneous intracerebral hemorrhage[J]. Practical Geriatrics, 2024, 38(6): 568-571.

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