HEMRICH量表对急性脑出血患者血肿扩大的预测价值

Predictive value of HEMRICH Scale for hematoma expansion in patients with acute intracerebral hemorrhage

目的探讨HEMRICH量表对急性脑出血患者血肿扩大的预测价值。方法收集整理发病6 h以内急性脑出血患者的临床资料188例,入院后24 h内行头颅CT复查,根据患者血肿是否扩大分为血肿扩大组46例和非血肿扩大组142例,对所有患者在入院当日使用HEMRICH量表进行评分,采用多因素Logistic回归分析血肿扩大的影响因素,采用受试者工作特征曲线评价HEMRICH量表对血肿扩大的预测价值。结果两组的HEMRICH量表分数比较差异有统计学意义(t=7.263,P<0.01)。多因素Logistic分析显示HEMRICH量表是脑出血血肿扩大的独立危险因素[OR(95%CI)=2.645(1.754~3.991),P<0.05]。受试者工作特征曲线分析结果显示HEMRICH量表预测血肿扩大的AUC为0.794,敏感度为73.91%,特异度83.80%。结论HEMRICH量表是急性脑出血血肿扩大的独立影响因素,HEMRICH量表对早期血肿扩大有一定的预测价值。

Objective To explore the predictive value of HEMRICH Scale for hematoma expansion(HE)in patients with acute intracerebral hemorrhage.Methods The clinical data of 188patients with acute intracerebral hemorrhage within 6 hours after onset were collected,head CT review was performed within 24 hours after admission,the patients were divided into HE group(46 cases)and non-HE group(142 cases)according to whether the hematoma was enlarged or not.All patients were scored using the HEMRICH Scale on admission.Multivariate Logistic regression was used to analyze the risk factors of HE,and receiver operating characteristic(ROC)curve was used to analyze the predictive value of HEMRICH Scale for HE.Results There was a significant difference in the scores of the HEMRICH Scale between the two groups(t=7.263,P<0.01).Multivariate Logistic analysis showed that HEMRICH Scale was the independent risk factor for HE[OR(95%CI)=2.645(1.754-3.991),P<0.05].ROC curve analysis showed that the AUC of HEMRICH Scale in predicting HE was 0.794,the sensitivity was 73.91%,and the specificity was 83.80%.Conclusion HEMRICH Scale is an independent risk factor for HE in acute intracerebral hemorrhage.The HEMRICH Scale has a certain predictive value for early HE.