高血压脑出血早期死亡危险的多因素分析

Multivariate analysis of risk factors of early death after hypertensive intracerebral hemorrhage

目的探讨脑出血早期死亡的危险因素,为临床患者的预后判断提供依据。方法检测110例24h内发生基底节出血患者入院时血糖、IL-6、vWF、TNF-α的血浆浓度,结合临床资料,对24h死亡概率进行单因素及多因素Logistic回归分析。结果单因素Logistic回归分析表明,男性、出血量大、高血压史和入院时高IL-6、TNF-α、收缩压、血糖是基底节出血24h死亡的危险因素(P<0.1),高vWF是保护因素(P<0.1)。多因素Logistic回归分析显示,高血压史、入院时高IL-6、血糖是基底节出血24h死亡的危险因素(P<0.1),高vWF是保护因素(P<0.1)。结论检测大脑基底节出血患者入院时血糖、IL-6、vWF的血浆浓度,结合高血压病史的有无,可能对早期死亡的预测有一定的临床指导意义。

Objective To investigate the risk factors of early death after hypertensive intracerebral hemorrhage and provide a basis for estimating the prognosis during clinical treatment. Methods The plasma concentrations of blood glucose, IL -6, vWF, TNF -α of 110 patients with intracerebral basal ganglia hemorrhage were determined respectively at admission, 24 - hour mortality was analyzed by univariate and muhivariate Logistic regression based on the clinical data. Results Male, large bleeding volume, hypertension history and high systolic pressure, high plasma concentrations of blood glucose, IL - 6, TNF - α at admission were risk factors of 24 - hour death after intraeerebral basal ganglia hemorrhage（P 〈 0.1 ） and high vWF was protective factor（ P 〈 0.1 ） by univariate Logistic regression analysis. Hypertension history and high plasma concentrations of blood glucose, IL - 6 at admission were risk factors of 24 - hours death after intraeerebral basal ganglia hemorrhage （ P 〈 0.1 ） and high vWF was still protective factor （ P 〈 0.1） by multivariate Logistic regression analysis. Conclusion The plasma concentrations of blood glucose, IL - 6, vWF of the patients with intracerebral basal ganglia hemorrhage at admission and with or without hypertension history are of significance in the prediction of 24 - hour death during clinical treatment.